Provider Demographics
NPI:1033576251
Name:BRIAN DAVEY DDS INC.
Entity Type:Organization
Organization Name:BRIAN DAVEY DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-538-8300
Mailing Address - Street 1:7805 HIGHLAND VILLAGE PL
Mailing Address - Street 2:STE G105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-5181
Mailing Address - Country:US
Mailing Address - Phone:858-538-8300
Mailing Address - Fax:858-538-8496
Practice Address - Street 1:7805 HIGHLAND VILLAGE PL
Practice Address - Street 2:STE G105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-5181
Practice Address - Country:US
Practice Address - Phone:858-538-8300
Practice Address - Fax:858-538-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty