Mr. BLAKE CARDON PORTER D.M.D.
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1417457524- Provider Type
- Individual Provider (NPI-1)
- Credentials
- D.M.D.
- Status
- Active
Contact & Location
- Address
- 3377 W LAZY J LN, LEHI, UT, 840436337
- Phone
- (480) 273-4544
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
License: ID #D-5568-OS
Student in an Organized Health Care Education/Training Program
License: IA #RES-30526
Dentist, Oral and Maxillofacial Surgery
Primary License: UT #7821520-9925