Provider Demographics
NPI:1477643534
Name:MAWYER, DAVID FRANKLIN (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FRANKLIN
Last Name:MAWYER
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 1:2675 CENTRAL AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6666
Mailing Address - Country:US
Mailing Address - Phone:406-652-9204
Mailing Address - Fax:406-652-9370
Practice Address - Street 1:2675 CENTRAL AVE STE 10
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6666
Practice Address - Country:US
Practice Address - Phone:406-652-9204
Practice Address - Fax:406-652-9370
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT14891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice