Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 7595 | NC |
NPI | 1033261615 |
---|---|
Provider Name | Dr. Amy Cummings Davidian |
First Address | Durham, NC 27713-7512 |
Second Address | Durham, NC 27713-7512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 27/03/2012 |