Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DEN.00203479 | CO |
NPI | 1053851485 |
---|---|
Provider Name | Allison Threlkeld Davis |
First Address | Littleton, CO 80127-5407 |
Second Address | Littleton, CO 80127-5407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2017 |
Last Update Date | 28/05/2021 |