Nicolette Therese Porttiin, DDS
Dentist in Avon, MN. Individual provider (NPI-1).
NPI number1457972770
StatusActive
Last updated in NPPESDec 13, 2021
Details
- NPI
- 1457972770
- Entity type
- Individual (NPI-1)
- Name
- Nicolette Therese Porttiin
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 27, 2020
- Certification date
- Dec 13, 2021
- Last updated
- Dec 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D14514 | MN | Yes |
Practice location
308 Blattner Dr # AAvon, MN 56310-4531
Phone 320-356-7374
Mailing address
308 Blattner Dr # AAvon, MN 56310-4531
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