Individual
DR. ROYCE ANTHONY PORTER JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3031 LYNDHURST AVE, WINSTON-SALEM, NC 27103-4007
(336) 765-9154
(336) 765-9291
Mailing address
3031 LYNDHURST AVE, WINSTON-SALEM, NC 27103-4007
(336) 765-9154
(336) 765-9291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5945
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8997012
—
NC
01
—
97012
BCBS PROVIDER ID
NC
Enumeration date
05/04/2006
Last updated
07/08/2007
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