Individual
DR. MERCEDES PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
606 24TH AVE S, SUITE 200, MINNEAPOLIS, MN 55454-1455
(612) 659-8689
Mailing address
606 24TH AVE S, SUITE 200, MINNEAPOLIS, MN 55454-1455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
R444
MN
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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