| NPI | 1841318110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R DAVENPORT Owner 520-886-2546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 1770) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 5426) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |