Organization
PEACHTREE PERIODONTICS & DENTAL IMPLANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROBERT DAVENPORT DMD, MS (DOCTOR)
(770) 487-7734
Entity
Organization
Contact information
Practice address
306 STEVENS ENTRY, PEACHTREE CITY, GA 30269-1325
(770) 487-7734
(770) 487-1783
Mailing address
306 STEVENS ENTRY, PEACHTREE CITY, GA 30269-1325
(770) 487-7734
(770) 487-1783
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
009974
GA
Other
Enumeration date
01/19/2007
Last updated
10/02/2012
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