Provider Demographics
NPI:1891879797
Name:DAVENPORT, DAVID FRANKLIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRANKLIN
Last Name:DAVENPORT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S TYLER ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3346
Mailing Address - Country:US
Mailing Address - Phone:985-892-2273
Mailing Address - Fax:985-892-2573
Practice Address - Street 1:604 S TYLER ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3346
Practice Address - Country:US
Practice Address - Phone:985-892-2273
Practice Address - Fax:985-892-2579
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice