| Porter Dentistry, P.c. | |
|
1633 W Main St # 200 Lebanon TN 37087-3423 | |
| (615) 449-3222 | |
| (615) 449-3202 |
| Full Name | Porter Dentistry, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1633 W Main St # 200, Lebanon, Tennessee |
| Authorized Official Name and Position | Tonia-marie D Porter (DENTIST/OWNER) |
| Authorized Official Contact | 6154493222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Porter Dentistry, P.c. 1633 W Main St # 200 Lebanon TN 37087-3423 Ph: (615) 449-3222 | Porter Dentistry, P.c. 1633 W Main St # 200 Lebanon TN 37087-3423 Ph: (615) 449-3222 |
| NPI Number | 1588984298 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 08/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588984298 | NPI | - | NPPES |
| 1530741 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8643 (Tennessee) | Primary |
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