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

LicenseStateTypeSpecialty
16458MAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Nantucket, MA

All providers in Nantucket, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.