MEDICARE: DR. ORLANDO R. MARTIN DMD

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	1916	PR

General Provider Information

NPI Number	:	1720086515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ORLANDO R. MARTIN DMD

Provider Business Mailing Address
First Line	:	2RR471 VIA 1
Second Line	:	VILLA FONTANA
City	:	CAROLINA
State	:	PR
Zip	:	00983-3857
Country	:	US
Telephone Number	:	787-750-7617
Fax Number	:

Provider Business Practice Location Address
First Line	:	2RR471 VIA 1
Second Line	:	VILLA FONTANA
City	:	CAROLINA
State	:	PR
Zip	:	00983-3857
Country	:	US
Telephone Number	:	787-750-7617
Fax Number	:

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	06/03/2015

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