Provider Demographics
NPI:1922253384
Name:JAMES E. DAVIS, D.D.S., P.S.
Entity Type:Organization
Organization Name:JAMES E. DAVIS, D.D.S., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-884-7197
Mailing Address - Street 1:530 VALLEY MALL PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4849
Mailing Address - Country:US
Mailing Address - Phone:509-884-7197
Mailing Address - Fax:509-886-1084
Practice Address - Street 1:530 VALLEY MALL PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4849
Practice Address - Country:US
Practice Address - Phone:509-884-7197
Practice Address - Fax:509-886-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 000066511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty