Davenport, Monica Annette

Davenport, Monica Annette is an sole proprietor health care provider with primary practice located at 1850 Martin Luther King Dr , Shreveport LA 71107-5020. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Davenport, Monica Annette can be contacted via phone (318) 226-0244.

Contact Information

Primary practice address
1850 Martin Luther King Dr Shreveport LA 71107-5020
Fax: (318) 226-0282
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5001 Louisiana

Profile Details

NPI number 1740224435
LBN Legal business name Davenport, Monica Annette
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2006
Last updated Feb 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740224435 NPPES
Louisiana MEDICAID 5001

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