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Individual

DR. MARK F PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
212 E MARKET ST, TROY, IL 62294-1512
(618) 667-6101
(618) 667-8099
Mailing address
9 RACHAEL CT, TROY, IL 62294-4010
(618) 667-8852

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19.015695
IL

Other

Enumeration date
02/26/2007
Last updated
07/08/2007
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