Provider Demographics
NPI:1215067632
Name:DAVIS, CHRISTOPHER M (DDS,PA)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:DAVIS
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Gender:M
Credentials:DDS,PA
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Mailing Address - Street 1:1422 MAIN ST
Mailing Address - Street 2:226
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7625
Mailing Address - Country:US
Mailing Address - Phone:817-481-7733
Mailing Address - Fax:817-481-6694
Practice Address - Street 1:1422 MAIN ST
Practice Address - Street 2:226
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7625
Practice Address - Country:US
Practice Address - Phone:817-481-7733
Practice Address - Fax:817-481-6694
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX185771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry