Provider Demographics
NPI:1417090242
Name:DAVIS, KRISTA SCHOBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:SCHOBERT
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 1:418 SOUTHRIDGE DR.
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968
Mailing Address - Country:US
Mailing Address - Phone:727-480-5527
Mailing Address - Fax:
Practice Address - Street 1:2202 N BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2761
Practice Address - Country:US
Practice Address - Phone:434-293-9916
Practice Address - Fax:434-293-3879
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist