Provider Demographics
NPI:1609438548
Name:DAVISON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DAVISON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-653-4100
Mailing Address - Street 1:1058 N IRISH RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2209
Mailing Address - Country:US
Mailing Address - Phone:810-653-4100
Mailing Address - Fax:810-658-7526
Practice Address - Street 1:1058 N IRISH RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2209
Practice Address - Country:US
Practice Address - Phone:810-653-4100
Practice Address - Fax:810-658-7526
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies