Provider Demographics
NPI:1043415649
Name:WILLIAM P. DAVIS DDS LLC
Entity Type:Organization
Organization Name:WILLIAM P. DAVIS DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-296-8460
Mailing Address - Street 1:615 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-1453
Mailing Address - Country:US
Mailing Address - Phone:614-296-8460
Mailing Address - Fax:740-922-6704
Practice Address - Street 1:615 N WATER ST
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1453
Practice Address - Country:US
Practice Address - Phone:614-296-8460
Practice Address - Fax:740-922-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty