Provider Demographics
NPI:1265672042
Name:DAVIS, VICTOR CARROLL (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:CARROLL
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 NEW HAMPSHIRE AVENUE
Mailing Address - Street 2:SUITE #330
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903
Mailing Address - Country:US
Mailing Address - Phone:301-928-8416
Mailing Address - Fax:240-313-9661
Practice Address - Street 1:10230 NEW HAMPSHIRE AVENUE
Practice Address - Street 2:SUITE #330
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903
Practice Address - Country:US
Practice Address - Phone:301-928-8416
Practice Address - Fax:240-313-9661
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD48031223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics