# SILAS PORTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rainaldi Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629729868
- **Authorized official:** SILAS MATTHEW PORTER DMD (OWNER/DENTIST)
- **Authorized official phone:** (505) 259-1595

## Contact information

- **Practice address:** 501 E NIZHONI BLVD, GALLUP, NM 87301-5899
- **Practice address phone:** (505) 863-9363
- **Mailing address:** 501 E NIZHONI BLVD, GALLUP, NM 87301-5899
- **Mailing address phone:** (505) 863-9363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/10/2022
- **Last updated:** 01/13/2022