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1043351786
JESSE PAUL PORTER
SAN DIEGO, CA
NPI
1043351786
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: CA 51189)
Additional Taxonomies
122300000X Dentist
(Licence: IL 019.016830)
Enumeration Date
2007-02-08
Last Update Date
2007-07-08
Business Address
Dr. JESSE PAUL PORTER DDS
2310 CRAVEN ST NDMC 32ND ST. BLDG. 3230
SAN DIEGO, CA 92136-5596
Phone number: 619-556-1581
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Mailing Address
Dr. JESSE PAUL PORTER DDS
1391 TOULON ST
OCEANSIDE, CA 92056-6559
Phone number: 760-724-9717
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