Provider Demographics
NPI:1902955412
Name:DAVIS, MILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12398 FM 423
Mailing Address - Street 2:1900
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4758
Mailing Address - Country:US
Mailing Address - Phone:214-436-4774
Mailing Address - Fax:
Practice Address - Street 1:12398 FM 423
Practice Address - Street 2:1900
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4758
Practice Address - Country:US
Practice Address - Phone:214-436-4774
Practice Address - Fax:214-436-4774
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry