Provider Demographics
NPI:1588874010
Name:DAVIS, MICHAEL A II (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:DAVIS
Suffix:II
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 1:5481 COLONY DR N
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-7189
Mailing Address - Country:US
Mailing Address - Phone:989-791-2060
Mailing Address - Fax:989-791-1889
Practice Address - Street 1:5481 COLONY DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-7189
Practice Address - Country:US
Practice Address - Phone:989-791-2060
Practice Address - Fax:989-791-1889
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI134341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice