Organization
DYNAMIC DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA YVONNE PORTER DDS (PRESIDENT)
(518) 274-6741
Entity
Organization
Contact information
Practice address
2121 6TH AVE, TROY, NY 12180-2849
(518) 274-6741
(518) 274-6748
Mailing address
2121 6TH AVE, TROY, NY 12180-2849
(518) 274-6741
(518) 274-6748
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
04449-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01568836
—
NY
Enumeration date
06/27/2011
Last updated
06/27/2011
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