Provider Demographics
NPI:1861565301
Name:DAVIS, DICK CALHOUN (DDS)
Entity type:Individual
Prefix:DR
First Name:DICK
Middle Name:CALHOUN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:CALHOUN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2777 N CAMPBELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-795-9202
Mailing Address - Fax:520-795-4987
Practice Address - Street 1:2777 N CAMPBELL AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-795-9202
Practice Address - Fax:520-795-4987
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist