Individual
DR. ANDREW W PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2533 BERT KOUNS INDUSTRIAL LOOP, SUITE 107, SHREVEPORT, LA 71118-3158
(318) 688-1040
(318) 688-3039
Mailing address
2533 BERT KOUNS INDUSTRIAL LOOP, SUITE 107, SHREVEPORT, LA 71118-3158
(318) 688-1040
(318) 688-3039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4101
LA
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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