Organization
DOWNTOWN FAMILY DENTAL OF WEST BEND, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE T. PORTER DDS (OWNER)
(262) 338-1164
Entity
Organization
Contact information
Practice address
309 N 7TH AVE, WEST BEND, WI 53095-3242
(262) 338-1164
(262) 338-1646
Mailing address
309 N 7TH AVE, WEST BEND, WI 53095-3242
(262) 338-1164
(262) 338-1646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1412
WI
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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