The Avenues Family Dentistry
NPI #1093018111 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1093018111
- Entity Type
- Organization
- Organization Name
- The Avenues Family Dentistry
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 11, 2010
- Last Updated
- Dec 11, 2010
Practice Location
- Address
- 215 S 1000 E STE A
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84102-2486
- Phone
- (801) 328-4173
Authorized Official
- Name
- DR. PAUL MARK PORTER, DDS
- Title
- PRESIDENT
- Phone
- (435) 760-0189
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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