Provider Demographics
NPI:1386835239
Name:DAVIS, RACHAEL ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-3461
Mailing Address - Country:US
Mailing Address - Phone:515-321-3725
Mailing Address - Fax:
Practice Address - Street 1:1345 E UNIVERSITY AVE
Practice Address - Street 2:#302
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2461
Practice Address - Country:US
Practice Address - Phone:515-264-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice