Provider Demographics
NPI:1346275997
Name:D. ALAN DAVIES DMD PC
Entity Type:Organization
Organization Name:D. ALAN DAVIES DMD PC
Other - Org Name:CEDAR VALLEY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:D.
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-586-9055
Mailing Address - Street 1:1251 N. NORTHFIELD RD.
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9746
Mailing Address - Country:US
Mailing Address - Phone:435-586-9055
Mailing Address - Fax:435-586-9104
Practice Address - Street 1:1251 N. NORTHFIELD RD.
Practice Address - Street 2:SUITE 310
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9746
Practice Address - Country:US
Practice Address - Phone:435-586-9055
Practice Address - Fax:435-586-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT51142999922122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty