Provider Demographics
NPI:1417108887
Name:DAVILA, BRIAN ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ALEXANDER
Last Name:DAVILA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7360 HIGHWAY 78
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-2606
Mailing Address - Country:US
Mailing Address - Phone:972-429-9911
Mailing Address - Fax:972-429-9918
Practice Address - Street 1:7360 HIGHWAY 78
Practice Address - Street 2:SUITE 100
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-2606
Practice Address - Country:US
Practice Address - Phone:972-429-9911
Practice Address - Fax:972-429-9918
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist