Provider Demographics
NPI:1356562375
Name:ROCKWELL F. DAVIS D.D.S.
Entity type:Organization
Organization Name:ROCKWELL F. DAVIS D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCKWELL
Authorized Official - Middle Name:FERMAN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-729-3571
Mailing Address - Street 1:16 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1504
Mailing Address - Country:US
Mailing Address - Phone:207-729-3571
Mailing Address - Fax:207-725-2801
Practice Address - Street 1:16 CENTER ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1504
Practice Address - Country:US
Practice Address - Phone:207-729-3571
Practice Address - Fax:207-725-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME34361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty