| NPI | 1255870051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN L DAVENPORT Owner 517-787-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901017187) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |