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Organization

DR. MONICA A. DAVENPORT, DDS APC

Active
Other names
Davenport Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MONICA ANNETTE DAVENPORT DDS (OWNER/DENTIST)
(318) 226-0244
Entity
Organization

Contact information

Practice address
1850 MARTIN LUTHER KING DR., SHREVEPORT, LA 71107-5020
(318) 226-0244
(318) 226-0282
Mailing address
1850 MARTIN LUTHER KING DR., SHREVEPORT, LA 71107-5020
(318) 226-0244
(318) 226-0282

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1850012
LA
Enumeration date
02/12/2016
Last updated
02/12/2016
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