Provider Demographics
NPI:1437156080
Name:DAVIS, DARWIN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARWIN
Middle Name:N
Last Name:DAVIS
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 1:3132 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5430
Mailing Address - Country:US
Mailing Address - Phone:602-265-8190
Mailing Address - Fax:602-265-8049
Practice Address - Street 1:3132 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5430
Practice Address - Country:US
Practice Address - Phone:602-265-8190
Practice Address - Fax:602-265-8049
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
AZAZ3783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist