Provider Demographics
NPI:1427795772
Name:GARRISON, DAVIS E (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVIS
Middle Name:E
Last Name:GARRISON
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 1:950 DORCHESTER WAY UNIT 319
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3929
Mailing Address - Country:US
Mailing Address - Phone:567-215-5140
Mailing Address - Fax:
Practice Address - Street 1:910 KATHERINE AVE STE A
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3692
Practice Address - Country:US
Practice Address - Phone:419-281-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026820122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist