Provider Demographics
NPI:1174575799
Name:DAVIS, CHRISTI MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTI
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11020 PRESIDIO DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7772
Mailing Address - Country:US
Mailing Address - Phone:919-293-0446
Mailing Address - Fax:
Practice Address - Street 1:10411 MONCREIFFE ROAD
Practice Address - Street 2:SUITE 105B
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-6452
Practice Address - Country:US
Practice Address - Phone:919-806-0200
Practice Address - Fax:919-806-0211
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902RUMedicaid