Provider Demographics
NPI:1053388546
Name:DAVIS, WILLIAM J JR (DDS MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DAVIS
Suffix:JR
Gender:
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25955 WILLOWBEND RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551
Mailing Address - Country:US
Mailing Address - Phone:419-383-4547
Mailing Address - Fax:419-383-6127
Practice Address - Street 1:2109 HUGHES DR FL 6
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3858
Practice Address - Country:US
Practice Address - Phone:419-291-7308
Practice Address - Fax:419-291-8095
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH159001223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0368669Medicaid
OH0368669Medicaid
T47159Medicare UPIN