Provider Demographics
NPI:1720196512
Name:DAVIS, ROBERT FRANCIS III (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:DAVIS
Suffix:III
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 1:813 GILMER RD
Mailing Address - Street 2:STE 1
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604
Mailing Address - Country:US
Mailing Address - Phone:903-297-3777
Mailing Address - Fax:903-297-2491
Practice Address - Street 1:813 GILMER RD
Practice Address - Street 2:STE 1
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604
Practice Address - Country:US
Practice Address - Phone:903-297-3777
Practice Address - Fax:903-297-2491
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14617122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist