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1154587434
BRIAN DAVID PORTER
MADISON, WI
NPI
1154587434
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WI 6266-015)
Enumeration Date
2008-08-06
Last Update Date
2013-06-18
Business Address
Dr. BRIAN DAVID PORTER DDS
5601 ODANA RD
MADISON, WI 53719-1207
Phone number: 608-222-3231
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Mailing Address
Dr. BRIAN DAVID PORTER DDS
1622 STATION PARK DR
GRAYSLAKE, IL 60030-2720
Phone number: 414-628-3716
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