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General NPI Number Information
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NPI Number | 1114176005
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Entity Type | Individual
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Provider Name | JUDITH ADKINS PORTER DDS, EDD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 650 W BALTIMORE ST RM 3209
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 410-706-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 650 W BALTIMORE ST RM 3209
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 410-706-2145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13892
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2216
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS-031485-L
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License Number State | PA
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