Individual
JACKSON LEGGETT PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4180 DELAWARE ST, 303, BEAUMONT, TX 77706-7858
(409) 899-2111
(409) 899-2821
Mailing address
4180 DELAWARE, 303, BEAUMONT, TX 77706
(409) 899-2111
(409) 899-2821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12315
TX
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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