Provider Demographics
NPI:1043381197
Name:DAVIS JR., HERBERT CRIPPON (DDS)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:CRIPPON
Last Name:DAVIS JR.
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:HERBERT
Other - Middle Name:CRIPPON
Other - Last Name:DAVIS JR.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:242 N TALBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-4143
Mailing Address - Country:US
Mailing Address - Phone:336-248-6790
Mailing Address - Fax:336-248-6796
Practice Address - Street 1:242 N TALBERT BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4143
Practice Address - Country:US
Practice Address - Phone:336-248-6790
Practice Address - Fax:336-248-6796
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice