Provider Demographics
NPI:1790785103
Name:DAVIES, DONALD BRIAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BRIAN
Last Name:DAVIES
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10751 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3256
Mailing Address - Country:US
Mailing Address - Phone:513-469-1121
Mailing Address - Fax:
Practice Address - Street 1:10751 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3256
Practice Address - Country:US
Practice Address - Phone:513-469-1121
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH195471223E0200X
MI124711223E0200X
CA352441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics