Provider Demographics
NPI:1417202813
Name:PORTER, DEBORAH F (RDH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:F
Last Name:PORTER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1814
Mailing Address - Country:US
Mailing Address - Phone:406-256-3886
Mailing Address - Fax:
Practice Address - Street 1:122 YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1814
Practice Address - Country:US
Practice Address - Phone:406-256-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT532124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist