Organization
JACKSON PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN L DAVENPORT DDS (OWNER)
(517) 787-1022
Entity
Organization
Contact information
Practice address
2500 SPRING ARBOR RD, JACKSON, MI 49203-3602
(517) 787-1022
Mailing address
2500 SPRING ARBOR RD, JACKSON, MI 49203-3602
(517) 787-1022
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901017187
MI
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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