# DAVENPORT DENTAL HYGIENE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629671425
- **Authorized official:** ELIZABETH CORENE DAVENPORT RDH (DENTAL HYGIENIST)
- **Authorized official phone:** (970) 585-4424

## Contact information

- **Practice address:** 450 LEWIS ST \# 3D, PAGOSA SPRINGS, CO 81147-7508
- **Practice address phone:** (970) 585-4424
- **Mailing address:** PO BOX 5803, PAGOSA SPRINGS, CO 81147-5803
- **Mailing address phone:** (970) 585-4424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2020
- **Last updated:** 11/16/2020