Individual
DR. GARTH THOMAS PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 21ST ST, US ARMY DENTAL L ACTIVITY, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
(270) 956-0266
Mailing address
2441 21ST ST, US ARMY DENTAL L ACTIVITY, FORT CAMPBELL, KY 42223-5582
(270) 798-8751
(270) 956-0266
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8046391-9921
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8046391-9921
UT
Other
Enumeration date
08/05/2011
Last updated
08/24/2016
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