Provider Demographics
NPI:1265815781
Name:DAVIES, CHASE RYAN (DDS)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:RYAN
Last Name:DAVIES
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 1:821 N WENATCHEE AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2063
Mailing Address - Country:US
Mailing Address - Phone:509-663-1566
Mailing Address - Fax:509-663-8776
Practice Address - Street 1:821 N WENATCHEE AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2063
Practice Address - Country:US
Practice Address - Phone:509-663-1566
Practice Address - Fax:509-663-8776
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605732301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice