Provider Demographics
NPI:1003282690
Name:DAVIES, RODERICK (DDS)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:
Last Name:DAVIES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4104
Mailing Address - Country:US
Mailing Address - Phone:813-600-5256
Mailing Address - Fax:808-438-4132
Practice Address - Street 1:5721 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4104
Practice Address - Country:US
Practice Address - Phone:813-600-5256
Practice Address - Fax:808-438-4132
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL248301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice