| NPI | 1770579542 |
|---|---|
| Former Name | AVIS M DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D6921) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE NE 6445) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2015-01-29 |