Provider Demographics
NPI:1922211317
Name:DAVIS, ROBERT CHARLES II (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
Last Name:DAVIS
Suffix:II
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 1:3300 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5100
Mailing Address - Country:US
Mailing Address - Phone:941-366-7565
Mailing Address - Fax:
Practice Address - Street 1:3300 S TAMIAMI TRL
Practice Address - Street 2:SUITE 4
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5100
Practice Address - Country:US
Practice Address - Phone:941-366-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN63301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice