MEDICARE: FRANK L DAVENPORT DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10112TX	TX

General Provider Information

NPI Number	:	1730282971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK L DAVENPORT DDS INC

Provider Business Mailing Address
First Line	:	909 DAIRY ASHFORD RD
Second Line	:	SUITE 111
City	:	HOUSTON
State	:	TX
Zip	:	77079
Country	:	US
Telephone Number	:	281-497-5558
Fax Number	:	281-497-7181

Provider Business Practice Location Address
First Line	:	909 DAIRY ASHFORD RD
Second Line	:	SUITE 111
City	:	HOUSTON
State	:	TX
Zip	:	77079-5306
Country	:	US
Telephone Number	:	281-497-5558
Fax Number	:	281-497-5558

Authorized Official
Title or Position	:	PRESIDENT & PRIMARY CARE PROVIDER
Name	:	DR. FRANK LESLIE DAVENPORT
Credential	:	DDS
Telephone Number	:	281-497-5558

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	08/22/2020

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