Individual
MS. ROSE MARY PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDA
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 728-3138
Mailing address
PO BOX 1101, FRANKLIN, VA 23851-1101
(757) 653-4213
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
CE# 132766
VA
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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