Brent J. Porter, D.D.S., M.S., A P.D.C.

LBN: Brent J. Porter, D.D.S., M.S., A P.D.C.
Brent J. Porter, D.D.S., M.S., A P.D.C. is an health care organization with primary practice located at 550 Water St Suite D Number 1, Santa Cruz CA 95060-4124. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / General Practice is the primary health care specialty. Brent J. Porter, D.D.S., M.S., A P.D.C. can be contacted via phone (831) 459-9802, or through Porter, Brent Joseph via phone (831) 459-9802.

Contact Information

Primary practice address
550 Water St Suite D Number 1 Santa Cruz CA 95060-4124
Phone: (831) 459-9802
Fax: (831) 459-8234
Website:
Map and Directions
Authorized official contact:
Name: Porter, Brent Joseph D.D.S., M.S.
Phone: (831) 459-9802

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 39322 California
Dental Providers / Pediatric Dentistry 1223P0221X 39322 California
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 39322 California

Profile Details

NPI number 1053523647
LBN Legal business name Brent J. Porter, D.D.S., M.S., A P.D.C.
DBA Doing business as
Authorized official Porter, Brent Joseph D.D.S., M.S.
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053523647 NPPES
California Other B39322 DENTICAL

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