Organization
MANDEVILLE DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID F DAVENPORT (OWNER/DENTIST)
(985) 674-3114
Entity
Organization
Contact information
Practice address
2581 FLORIDA STREET, SUITE A, MANDEVILLE, LA 70448
(985) 674-3114
(985) 892-2579
Mailing address
2581 FLORIDA STREET, SUITE A, MANDEVILLE, LA 70448
(985) 674-3114
(985) 892-2579
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5713
LA
Other
Enumeration date
06/23/2009
Last updated
06/23/2009
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