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General NPI Number Information
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NPI Number | 1891073557
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Entity Type | Individual
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Provider Name | JAMES MICHAEL DAVENPORT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 10220 W MARKHAM ST SUITE 101
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2189
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Country | US
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Telephone | 501-666-7623
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Fax | 501-666-3410
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Provider Business Mailing Address
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Address Line | 8 WOODBERRY RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-2742
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Country | US
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Telephone | 501-912-3487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3482
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License Number State | AR
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