Individual
LATIFAH SERITA PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
USA DENTAL HEALTH ACTIVITY, 652 HAMILTON ROAD, FT SILL, OK 73503
(580) 442-3905
Mailing address
USA DENTAL HEALTH ACTIVITY, 652 HAMILTON ROAD, FT SILL, OK 73503
(580) 442-3905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041438
PA
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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