Provider Demographics
NPI:1285622357
Name:DAVIS, WILLIAM HAROLD (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HAROLD
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 1:2 GARDEN CTR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7082
Mailing Address - Country:US
Mailing Address - Phone:303-460-7830
Mailing Address - Fax:303-460-7830
Practice Address - Street 1:2 GARDEN CTR
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7082
Practice Address - Country:US
Practice Address - Phone:303-460-7830
Practice Address - Fax:303-460-7830
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO64011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice