Provider Demographics
NPI:1104280098
Name:CATHEY G. DAVIS, DMD, LLC
Entity type:Organization
Organization Name:CATHEY G. DAVIS, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-978-6700
Mailing Address - Street 1:1932 LAUREL RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1859
Mailing Address - Country:US
Mailing Address - Phone:205-978-6700
Mailing Address - Fax:205-978-7351
Practice Address - Street 1:1932 LAUREL RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1859
Practice Address - Country:US
Practice Address - Phone:205-978-6700
Practice Address - Fax:205-978-7351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3664261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental