Provider Demographics
NPI:1083993588
Name:DAVIS, CHASE DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:DANIEL
Last Name:DAVIS
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 1:3010 E FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5261
Mailing Address - Country:US
Mailing Address - Phone:480-917-8400
Mailing Address - Fax:
Practice Address - Street 1:2095 W FRYE RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6280
Practice Address - Country:US
Practice Address - Phone:480-917-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0082891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice