DR. Phillip Charles Portera, D.M.D.
NPI #1437148483 in Keesler Afb, Mississippi
Provider Information
- NPI Number
- 1437148483
- Entity Type
- Individual
- Name
- DR. Phillip Charles Portera, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D.
- Enumeration Date
- Oct 20, 2005
- Last Updated
- Apr 30, 2018
Practice Location
- Address
- 301 FISHER ST
- City
- Keesler Afb
- State
- Mississippi
- ZIP Code
- 39534-2508
- Phone
- (228) 376-0511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - General Practice — General Practice |
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