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Individual

DR. NATHAN RAY PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
855 E BROWN RD, SUITE 4, MESA, AZ 85203-4958
(480) 834-6100
Mailing address
855 E BROWN RD, SUITE 4, MESA, AZ 85203-4958
(480) 834-6100

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7582
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
350633
AZ
Enumeration date
07/09/2008
Last updated
04/19/2012
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