Davis, Michael William

Davis, Michael William is an sole proprietor health care provider with primary practice located at 133 Clebourne St , Fort Mill SC 29715-1742. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Davis, Michael William can be contacted via phone (803) 547-7508.

Contact Information

Primary practice address
133 Clebourne St Fort Mill SC 29715-1742
Fax: (803) 547-1070
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1880 South Carolina

Profile Details

NPI number 1750461083
LBN Legal business name Davis, Michael William
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1750461083 NPPES
South Carolina Other 408030 UNITED CONCORDIA
South Carolina MEDICAID ZA9804 UNITED CONCORDIA

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