Individual provider · NPI-1

Dr. Glenn Davis, D.D.S.

Dentist, General Practice · Shawnee, OK

NPI number1437198017
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1437198017
Entity type
Individual (NPI-1)
Name
Dr. Glenn Davis
Credential
D.D.S.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 6, 2006
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice3839OKYes

Practice location

3703 N Kickapoo Ave
Shawnee, OK 74804-1703

Phone 405-275-0640 · Fax 405-275-1502

Mailing address

3703 N Kickapoo Ave
Shawnee, OK 74804-1703

Phone 405-275-0640 · Fax 405-275-1502

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