Individual
GARY AUSTIN PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 247-9008
Mailing address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 247-9008
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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