Provider Demographics
NPI:1346370046
Name:JAMES G DAVIS DDS PC
Entity Type:Organization
Organization Name:JAMES G DAVIS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-945-2119
Mailing Address - Street 1:4520 NELSON BROGDON BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3478
Mailing Address - Country:US
Mailing Address - Phone:770-945-2119
Mailing Address - Fax:770-945-0979
Practice Address - Street 1:4520 NELSON BROGDON BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-3478
Practice Address - Country:US
Practice Address - Phone:770-945-2119
Practice Address - Fax:770-945-0979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty