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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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