Individual
COREY J PORCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
103 SOUTHDOWN WEST BLVD, HOUMA, LA 70360
(985) 876-5564
Mailing address
103 SOUTHDOWN WEST BLVD, HOUMA, LA 70360-3943
(985) 876-5564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5582
LA
Other
Enumeration date
09/06/2012
Last updated
05/15/2018
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