MEDICARE: DR. PHILIP JAMES MARTOWSKI D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14620	FL

General Provider Information

NPI Number	:	1295869659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP JAMES MARTOWSKI D.D.S.

Provider Business Mailing Address
First Line	:	886 DAHLIA LN
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-4914
Country	:	US
Telephone Number	:	772-231-6949
Fax Number	:	772-231-6533

Provider Business Practice Location Address
First Line	:	886 DAHLIA LN
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-4914
Country	:	US
Telephone Number	:	772-231-6949
Fax Number	:	772-231-6533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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