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Individual

DR. JEFFREY LEE PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
201 BRIDGE PARK DRIVE, CHARLEVOIX, MI 49720-1381
(231) 547-9516
(231) 547-9526
Mailing address
201 BRIDGE PARK DRIVE, CHARLEVOIX, MI 49720
(231) 547-9516
(231) 547-9526

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901009449
MI

Other

Enumeration date
02/13/2008
Last updated
02/13/2008
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