Shane Davidson DDS PC

NPI #1033651427 in Waterford, Michigan

Provider Information

NPI Number: 1033651427
Entity Type: Organization
Organization Name: Shane Davidson DDS PC
Subpart: Yes (part of a larger organization)
Parent Organization: SHANE DAVIDSON DDS PC
Primary Specialty: Dentist
Enumeration Date: Nov 16, 2016
Last Updated: Nov 16, 2016

Practice Location

Address: 5574 COOLEY LAKE RD
City: Waterford
State: Michigan
ZIP Code: 48327-3015
Phone: (248) 977-3006

Authorized Official

Name: SHANE DAVIDSON, DDS
Title: OWNER
Phone: (248) 977-3006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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