Robert William Davidson, DDS
Individual provider Active NPI Dentist · Freeland, MI
NPI 1447445796 · NPPES record last updated Sep 10, 2007
Key facts
- NPI
- 1447445796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 11024 (MI)
- Practice address
- 9625 Pierce Rd
Freeland, MI 48623-8102 - Phone
- (989) 695-9880
- NPI assigned
- Sep 10, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11024 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11024 | MI | Yes |
Addresses
Primary practice location
9625 Pierce Rd
Freeland, MI 48623-8102
Mailing address
9625 Pierce Rd
Freeland, MI 48623-8102
Phone (989) 695-9880
Other providers in Freeland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.