Individual
DR. MICHAEL SCOTT PORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9533 FENWAY AVE, BATON ROUGE, LA 70809-1411
(225) 925-1021
Mailing address
10908 GATEWOOD DR, BATON ROUGE, LA 70810-2911
(225) 766-7511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4100
LA
Other
Enumeration date
07/23/2006
Last updated
07/08/2007
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