Individual
MEGAN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1611 N. WOLCOTT AVE., CHICAGO, IL 60622-1362
(312) 281-4860
Mailing address
2668 N HALSTED ST APT 202, CHICAGO, IL 60614-7683
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019030175
IL
Other
Enumeration date
07/19/2011
Last updated
10/28/2015
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