Individual
DR. STANLEY M PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
7946 BUSTLETON AVE, PHILADELPHIA, PA 19152-3321
(215) 725-8901
(215) 725-8951
Mailing address
7946 BUSTLETON AVE, PHILADELPHIA, PA 19152-3321
(215) 725-8901
(215) 725-8951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS021553L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723043
UNITED CONC. PROV #
PA
Enumeration date
06/07/2006
Last updated
07/08/2007
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