Organization
SILAS PORTER, LLC
Active
Other names
Rainaldi Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SILAS MATTHEW PORTER DMD (OWNER/DENTIST)
(505) 259-1595
Entity
Organization
Contact information
Practice address
501 E NIZHONI BLVD, GALLUP, NM 87301-5899
(505) 863-9363
Mailing address
501 E NIZHONI BLVD, GALLUP, NM 87301-5899
(505) 863-9363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/13/2022
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