Provider Demographics
NPI:1386475358
Name:AUSTIN R DAVIS DMD PLLC
Entity type:Organization
Organization Name:AUSTIN R DAVIS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:REECE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:910-352-4373
Mailing Address - Street 1:3689 MERESTONE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-5189
Mailing Address - Country:US
Mailing Address - Phone:910-352-4373
Mailing Address - Fax:
Practice Address - Street 1:7864 US HWY 117 S
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NC
Practice Address - Zip Code:28457-9458
Practice Address - Country:US
Practice Address - Phone:205-891-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty