Individual
THIAGO SOARES PORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSC, PHD
Contact information
Practice address
801 NEWTON RD, IOWA CITY, IA 52242-1001
(319) 335-7440
(319) 335-7451
Mailing address
322 DENTAL SCIENCE BLDG S, IOWA CITY, IA 52242-1001
(193) 335-7440
(319) 335-7451
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
71.000256
OH
1223G0001X
General Practice Dentistry
Primary
FAC-40210
IA
Other
Enumeration date
11/07/2018
Last updated
07/20/2022
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