Provider Demographics
NPI:1598039372
Name:ERIC DAVIS DDS PLLC
Entity Type:Organization
Organization Name:ERIC DAVIS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-644-1800
Mailing Address - Street 1:603 HAMPTON POINTE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278
Mailing Address - Country:US
Mailing Address - Phone:919-644-1800
Mailing Address - Fax:919-644-1500
Practice Address - Street 1:603 HAMPTON POINTE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278
Practice Address - Country:US
Practice Address - Phone:919-644-1800
Practice Address - Fax:919-644-1500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907816Medicaid
NC2063124OtherUNITED CONCORDIA