Davis Wayne Gardner, DDS

Individual provider Active NPI General Practice Dentistry · Windsor, VA

NPI 1386955508 · NPPES record last updated Jun 23, 2010

Key facts

NPI
1386955508
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401412847 (VA)
Practice address
70 E Windsor Blvd Ste D
Windsor, VA 23487-9443
Phone
(804) 359-5733
Fax
(757) 242-6789
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401412847VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harold F. Demsko, D.D.S.,P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401412847 VA Yes

Addresses

Primary practice location

70 E Windsor Blvd Ste D
Windsor, VA 23487-9443

Mailing address

70 E Windsor Blvd Ste D
Windsor, VA 23487-9443
Phone (804) 359-5733

Other providers in Windsor, VA

All providers in Windsor, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.