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General NPI Number Information
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NPI Number | 1518314533
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Entity Type | Organization
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Legal Business Name | DENTON DAVENPORT DO, PLLC
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 9140 W. THOMAS ROAD, STE. B-106
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City | PHOENIX
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State | AZ
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Zip | 85037
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Country | US
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Telephone | 602-475-5646
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Fax | 602-277-8146
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Provider Business Mailing Address
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Address Line | 10133 N 92ND ST., SUITE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85258
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Country | US
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Telephone | 602-475-5646
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Fax | 602-277-8146
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENTON R DAVENPORT
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Credential | D.O.
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Telephone | 602-308-7817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 6600
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License Number State | AZ
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