Provider Demographics
NPI:1548607724
Name:DAVENPORT, VANESSA TWINING (DDS)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:TWINING
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 ALLENDALE OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1533
Mailing Address - Country:US
Mailing Address - Phone:956-244-2787
Mailing Address - Fax:
Practice Address - Street 1:5250 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7017
Practice Address - Country:US
Practice Address - Phone:210-349-3368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist