Provider Demographics
NPI:1881881969
Name:DAVIS, KENT F (DDS)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:F
Last Name:DAVIS
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 1:2335 E VALLEY PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-2773
Mailing Address - Country:US
Mailing Address - Phone:760-741-9693
Mailing Address - Fax:760-741-9793
Practice Address - Street 1:2335 E VALLEY PKWY STE C
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-2773
Practice Address - Country:US
Practice Address - Phone:760-741-9693
Practice Address - Fax:760-741-9793
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADY266191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice