Davenport Family Dentistry, LLC

Contacts

Phone	+1 256-355-0185
Fax	2565840100

Authorized person

Name	DR. JUSTIN M BISHOP
Role	OWNER/DENTIST
Phone	2563550185

Taxonomy

Taxonomy Code	1223G0001X - General Practice Dentistry
Is Primary	Yes

Other Provider Identifiers

Issuer	NPI
Number	1437684107
State	AL

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621210
Sponsor’s telephone number	2563551085
Plan sponsor’s address	2020 STRATFORD CT. SE, DECATUR, AL, 35601

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621210
Sponsor’s telephone number	2563551744
Plan sponsor’s address	431 JOHNSTON STREET SE, DECATUR, AL, 35601

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2006-01-01
Business code	621210
Sponsor’s telephone number	2563551744
Plan sponsor’s address	431 JOHNSTON STREET SE, DECATUR, AL, 35601