Provider Demographics
NPI:1548334105
Name:DAVIS, ANN MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 B NORTH COURT STREET
Mailing Address - Street 2:PO BOX 69
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164
Mailing Address - Country:US
Mailing Address - Phone:270-237-3521
Mailing Address - Fax:270-237-5254
Practice Address - Street 1:306 B NORTH COURT STREET
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164
Practice Address - Country:US
Practice Address - Phone:270-237-3521
Practice Address - Fax:270-237-5254
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY77471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice