Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 30-023900 | OH |
NPI | 1205198124 |
---|---|
Provider Name | Dr. April R Davis |
First Address | Sandusky, OH 44870-7939 |
Second Address | Toledo, OH 43606-1174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0087352 | (05) | OH |
H206960 | MEDICARE (01) |