Provider Demographics
NPI:1306011531
Name:DAVIS AND BEYER DENTAL HEALTH PROFESSIONALS
Entity Type:Organization
Organization Name:DAVIS AND BEYER DENTAL HEALTH PROFESSIONALS
Other - Org Name:DAVIS AND BEYER DDS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-488-1075
Mailing Address - Street 1:1218 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2151
Mailing Address - Country:US
Mailing Address - Phone:941-488-1075
Mailing Address - Fax:941-484-6277
Practice Address - Street 1:1218 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2151
Practice Address - Country:US
Practice Address - Phone:941-488-1075
Practice Address - Fax:941-484-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN114341223G0001X
FLDN134061223G0001X
FLDN120861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty