Individual
MRS. ALISHA BROOKE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
240 PARK PL, AZLE, TX 76020-3230
(817) 444-1763
(817) 270-4076
Mailing address
240 PARK PL, AZLE, TX 76020-3230
(817) 444-1763
(817) 270-4076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18701
TX
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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