Provider Demographics
NPI:1174668206
Name:DRS. KURTIS AND JOANNE DAVIS, P.C.
Entity Type:Organization
Organization Name:DRS. KURTIS AND JOANNE DAVIS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KURTIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-389-0389
Mailing Address - Street 1:1100 EAGLES LANDING PKWY
Mailing Address - Street 2:STE. A
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7271
Mailing Address - Country:US
Mailing Address - Phone:770-389-0389
Mailing Address - Fax:770-389-8644
Practice Address - Street 1:1100 EAGLES LANDING PKWY
Practice Address - Street 2:STE. A
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7271
Practice Address - Country:US
Practice Address - Phone:770-389-0389
Practice Address - Fax:770-389-8644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty