| Brent J. Porter, D.d.s., M.s., A P.d.c. | |
|
550 Water St Suite D Number 1 Santa Cruz CA 95060-4124 | |
| (831) 459-9802 | |
| (831) 459-8234 |
| Full Name | Brent J. Porter, D.d.s., M.s., A P.d.c. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 550 Water St, Santa Cruz, California |
| Authorized Official Name and Position | Brent Joseph Porter (PRESIDENT-DENTIST) |
| Authorized Official Contact | 8314599802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent J. Porter, D.d.s., M.s., A P.d.c. Po Box 580 Aptos CA 95001-0580 Ph: (831) 459-9802 | Brent J. Porter, D.d.s., M.s., A P.d.c. 550 Water St Suite D Number 1 Santa Cruz CA 95060-4124 Ph: (831) 459-9802 |
| NPI Number | 1053523647 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053523647 | NPI | - | NPPES |
| B39322 | Other | CA | DENTICAL |
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