Individual
SILAS MATTHEW PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
575 S ALAMEDA BLVD, LAS CRUCES, NM 88005
(575) 528-6470
(575) 556-2930
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4708
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53234049
—
NM
Enumeration date
07/03/2017
Last updated
06/11/2019
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