Provider Demographics
NPI:1679338420
Name:DAVIS, VICTORIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:KEMYA CHLOE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:115 AMBASSADOR PVT CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2491
Mailing Address - Country:US
Mailing Address - Phone:773-580-8693
Mailing Address - Fax:
Practice Address - Street 1:115 AMBASSADOR PVT CIR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2491
Practice Address - Country:US
Practice Address - Phone:773-580-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program