MARK DOUGLAS PORTA

BATON ROUGE, LA
NPI1982724431
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: LA  3728)
Enumeration Date2007-03-29
Last Update Date2007-07-08
Business Address
-- MARK DOUGLAS PORTA d.d.s.
9533 FENWAY AVE
BATON ROUGE, LA 70809-1411
Phone number: 225-925-0951
Mailing Address
-- MARK DOUGLAS PORTA d.d.s.
9533 FENWAY AVE
BATON ROUGE, LA 70809-1411
Phone number: 225-925-0951
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