Provider Demographics
NPI:1699208223
Name:DAVILLIER, CHRISTIAN (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:DAVILLIER
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 1:1825 7TH ST NW APT 311
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3192
Mailing Address - Country:US
Mailing Address - Phone:770-490-2433
Mailing Address - Fax:
Practice Address - Street 1:4400 BAYOU BLVD STE 27
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2691
Practice Address - Country:US
Practice Address - Phone:850-476-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN224681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics