Provider Demographics
NPI:1366652539
Name:DAVIS, TRUMON D (DDS)
Entity type:Individual
Prefix:DR
First Name:TRUMON
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8818 TYLER DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-6528
Mailing Address - Country:US
Mailing Address - Phone:940-725-0305
Mailing Address - Fax:
Practice Address - Street 1:651 N DENTON TAP RD STE 170
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7937
Practice Address - Country:US
Practice Address - Phone:972-899-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist