Individual
COLLIN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
110 S IDAHO RD STE 260, APACHE JUNCTION, AZ 85119-2379
(480) 982-0782
Mailing address
1911 E PARK AVE, GILBERT, AZ 85234-6107
(480) 577-5687
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D012155
AZ
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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