# NATE PORTER DDS PLC

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

## Provider details

- **NPI number:** 1861751661
- **Authorized official:** DR. NATHAN R PORTER DDS (CEO)
- **Authorized official phone:** (480) 834-6100

## Contact information

- **Practice address:** 855 E BROWN RD STE 4, MESA, AZ 85203-4958
- **Practice address phone:** (480) 834-6100
- **Mailing address:** 855 E BROWN RD STE 4, MESA, AZ 85203-4958
- **Mailing address phone:** (480) 834-6100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7582 | AZ | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 05/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 350633 | — | AZ |