Provider Demographics
NPI:1124282900
Name:DAVIS, JOSHUA MICHAEL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 BUFFALO GAP RD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3375
Mailing Address - Country:US
Mailing Address - Phone:325-695-7668
Mailing Address - Fax:
Practice Address - Street 1:4601 BUFFALO GAP RD
Practice Address - Street 2:SUITE C-1
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-3375
Practice Address - Country:US
Practice Address - Phone:325-695-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics