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DR. SUSAN RENEE DAVIS DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1386647600

Individual Registrant:
DR. SUSAN RENEE DAVIS DDS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
703 S OKLAHOMA DRIVE  LAVERNE, OK 73848-1230 US
Tel: 580-921-3343  Fax: 580-921-3334

Contact information for business:
PO BOX 1230  LAVERNE, OK 73848-1230 US
Tel: 580-921-5747  Fax: 580-921-3334

Registration Information:
NPI: 1386647600
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
OK4821

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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