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Organization
PERMIAN BASIN ORAL SURGERY & DENTAL IMPLANT CENTER
Active
Organization
PERMIAN BASIN ORAL SURGERY & DENTAL IMPLANT CENTER
Active
Other names
Permian Basin Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN ERIC PORTER D.D.S. M.D. (PRESIDENT)
(432) 333-6585
Entity
Organization
Contact information
Practice address
8101 DORADO DR, ODESSA, TX 79765-8533
(432) 333-6585
Mailing address
8101 DORADO DR, ODESSA, TX 79765-8533
(432) 333-6585
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/12/2007
Last updated
07/12/2016
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