Provider Demographics
NPI:1003983255
Name:SHARON D PORTER DDS INC
Entity Type:Organization
Organization Name:SHARON D PORTER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VONDENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-576-4611
Mailing Address - Street 1:PO BOX 1999
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77580
Mailing Address - Country:US
Mailing Address - Phone:281-576-4611
Mailing Address - Fax:281-576-4451
Practice Address - Street 1:11330 EAGLE DRIVE
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77580
Practice Address - Country:US
Practice Address - Phone:281-576-4611
Practice Address - Fax:281-576-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty