Individual
DR. THOMAS GAVIN PORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(267) 207-7107
Mailing address
208 N LEXINGTON AVE, HAVERTOWN, PA 19083-5006
(267) 207-7107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043337
PA
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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