Individual
DR. LAWRENCE THOMAS PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
309 N 7TH AVE, WEST BEND, WI 53095-3242
(262) 338-1164
(262) 338-1646
Mailing address
309 N 7TH AVE, WEST BEND, WI 53095-3242
(262) 338-1164
(262) 338-1646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1412
WI
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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