Provider Demographics
NPI:1790998813
Name:WILLIAM R. DAVIDSON, D.D.S.& ASSOC., INC.
Entity Type:Organization
Organization Name:WILLIAM R. DAVIDSON, D.D.S.& ASSOC., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-467-6066
Mailing Address - Street 1:9365 OLDE 8 RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2052
Mailing Address - Country:US
Mailing Address - Phone:330-467-6066
Mailing Address - Fax:330-467-0504
Practice Address - Street 1:9365 OLDE 8 RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2052
Practice Address - Country:US
Practice Address - Phone:330-467-6066
Practice Address - Fax:330-467-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-016734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty