Provider Demographics
NPI:1457354144
Name:DAVIDSON, DANNY EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:EUGENE
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:108 22ND AVE SW
Mailing Address - Street 2:STE 16
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2871
Mailing Address - Country:US
Mailing Address - Phone:360-943-5775
Mailing Address - Fax:360-943-6349
Practice Address - Street 1:108 22ND AVE SW
Practice Address - Street 2:STE 16
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2871
Practice Address - Country:US
Practice Address - Phone:360-943-5775
Practice Address - Fax:360-943-6349
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA56991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry