Roy M Davis, DMD
Individual provider Active NPI General Practice Dentistry · Nantucket, MA
NPI 1962669770 · NPPES record last updated May 20, 2008
Key facts
- NPI
- 1962669770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 16458 (MA)
- Practice address
- 11 Amelia Drive
Nantucket, MA 02554 - Phone
- (508) 228-6502
- Fax
- (508) 228-7658
- NPI assigned
- May 20, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 16458 | MA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16458 | MA | Yes |
Addresses
Primary practice location
11 Amelia Drive
Nantucket, MA 02554
Mailing address
11 Amelia Drive
Nantucket, MA 02554
Phone (508) 228-6502
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- Suzanne M Davis
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- Tamara R Dildy
All providers in Nantucket, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2008. 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.