Basic Information
| Provider Information | |||||||||
| NPI: | 1386892453 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORFIR | ||||||||
| FirstName: | IOANA | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9090 SKILLMAN ST STE 200C | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752438263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143405757 | ||||||||
| FaxNumber: | 2143404868 | ||||||||
| Practice Location | |||||||||
| Address1: | 2628 MATLOCK RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760152525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174683077 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2008 | ||||||||
| LastUpdateDate: | 11/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 24228 | TX | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.