Organization
THE AVENUES FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MARK PORTER DDS (PRESIDENT)
(435) 760-0189
Entity
Organization
Contact information
Practice address
215 S 1000 E STE A, SALT LAKE CITY, UT 84102-2486
(801) 328-4173
(801) 322-3995
Mailing address
215 S 1000 E STE A, SALT LAKE CITY, UT 84102-2486
(801) 328-4173
(801) 322-3995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7828837
UT
Other
Enumeration date
12/11/2010
Last updated
12/11/2010
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