Davenport, William L

Davenport, William L is an individual health care provider with primary practice located at 2240 Coliseum Dr , Hampton VA 23666-5903. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Davenport, William L can be contacted via phone (757) 595-1457.

Contact Information

Primary practice address
2240 Coliseum Dr Hampton VA 23666-5903
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 0401005717 Virginia

Profile Details

NPI number 1093798696
LBN Legal business name Davenport, William L
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Jul 8th, 2007 - about 17 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 1093798696 NPPES
Virginia Other 584223 UNITED CONCORDIA
Virginia MEDICAID 8000174 UNITED CONCORDIA
Virginia Other 0009509 UNITED CONCORDIA
Virginia Other 441659 UNITED CONCORDIA

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