Provider Demographics
NPI:1528007077
Name:DAVIS, JAMES EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
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 1:530 VALLEY MALL PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4849
Mailing Address - Country:US
Mailing Address - Phone:509-884-7197
Mailing Address - Fax:509-886-1084
Practice Address - Street 1:530 VALLEY MALL PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4849
Practice Address - Country:US
Practice Address - Phone:509-884-7197
Practice Address - Fax:509-886-1084
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000066511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice