Davis, Dustin Michael
Davis, Dustin Michael is an individual health care provider with primary practice located at 11411 Se Sunnyside Rd Ste 101 , Clackamas OR 97015-9356. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Davis, Dustin Michael can be contacted via phone (503) 855-5100.Contact Information
Primary practice address
11411 Se Sunnyside Rd Ste 101
Clackamas OR 97015-9356
Phone: (503) 855-5100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DEN.00202313 | Colorado |
| Dental Providers / Pediatric Dentistry | 1223P0221X | DE60650351 | Washington |
| Dental Providers / Pediatric Dentistry | 1223P0221X | D11447 | Oregon |
| Dental Providers / Dentist | 122300000X | 019029333 | Illinois |
Profile Details
| NPI number | 1063787497 |
|---|---|
| LBN Legal business name | Davis, Dustin Michael |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2012 |
| Last updated | Jun 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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