Provider Demographics
NPI:1427008044
Name:DAVIS, WILLIAM KENT (DDS MS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KENT
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 1:1025 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3930
Mailing Address - Country:US
Mailing Address - Phone:970-493-2254
Mailing Address - Fax:970-493-0940
Practice Address - Street 1:1025 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3930
Practice Address - Country:US
Practice Address - Phone:970-493-2254
Practice Address - Fax:970-493-0940
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODENTISTRY 34591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry