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General NPI Number Information
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NPI Number | 1043302938
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Entity Type | Organization
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Legal Business Name | GREGORY DAVENPORT DDS & JOHN ROHRABAUGH DDS INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 277 S HIGH STREET
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City | CORTLAND
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State | OH
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Zip | 44410
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Country | US
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Telephone | 330-638-7796
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Fax | 330-637-5218
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Provider Business Mailing Address
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Address Line | 277 S HIGH STREET
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City | CORTLAND
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State | OH
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Zip | 44410
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Country | US
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Telephone | 330-638-5481
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. GREGORY ALAN DAVENPORT
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Credential | DDS
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Telephone | 330-638-7796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18276
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14829
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License Number State | OH
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