Provider Demographics
NPI:1740357896
Name:DAVIDSON, GERARD A (DDS)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:A
Last Name:DAVIDSON
Suffix:
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 1:1400 SPRING ST STE 420
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2754
Mailing Address - Country:US
Mailing Address - Phone:301-585-3777
Mailing Address - Fax:301-608-3016
Practice Address - Street 1:1400 SPRING ST STE 420
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2754
Practice Address - Country:US
Practice Address - Phone:301-585-3777
Practice Address - Fax:301-608-3016
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice