Latifah Serita Porter

NPI #1518481324 in Ft Sill, Oklahoma

Provider Information

NPI Number: 1518481324
Entity Type: Individual
Name: Latifah Serita Porter
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Aug 2, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: USA DENTAL HEALTH ACTIVITY
Address 2: 652 HAMILTON ROAD
City: Ft Sill
State: Oklahoma
ZIP Code: 73503
Phone: (580) 442-3905

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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