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Mr. Blake Cardon Porter, DMD
Oral and Maxillofacial Surgery (Dentist) in Lehi, Utah
NPI 1417457524

Blake Cardon Porter is a Oral and Maxillofacial Surgery (Dentist) based in Lehi, UT and is specialized in Oral and Maxillofacial Surgery. Blake Cardon Porter practices in Lehi, UT and has the professional credentials of DMD. The NPI Number for Blake Cardon Porter is 1417457524 and holds a License No. D-5568-OS (Utah).

The current practice location address for Blake Cardon Porter is 3377 W Lazy J Ln, Lehi, UT and can be reached out via phone at 480-273-4544.

Location: 3377 W Lazy J Ln, Lehi, UT, 84043-6337
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417457524
Provider Name
Blake Cardon Porter
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
3377 W Lazy J Ln, Lehi, UT, 84043-6337
Phone Number
480-273-4544
Fax Number
Provider Enumeration Date
02/15/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3377 W Lazy J Ln
City
Lehi
State
Utah
Zip
84043-6337
Phone Number
480-273-4544
Fax Number
person
Provider Business Mailing Address Details
Address
3377 W Lazy J Ln
City
Lehi
State
Utah
Zip
84043-6337
Phone Number
480-273-4544
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
RES-30526 (Iowa)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
D-5568-OS (Idaho)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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