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General NPI Number Information
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NPI Number | 1104226398
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Entity Type | Organization
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Legal Business Name | ANTHONY MARTIN DMD, INC.
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 161 CAPITAL DR SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3392
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Country | US
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Telephone | 865-690-6691
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Fax | 865-690-9175
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Provider Business Mailing Address
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Address Line | 161 CAPITAL DR SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3392
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Country | US
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Telephone | 865-690-6691
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Fax | 865-690-9175
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY ANDREW MARTIN
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Credential | DMD
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Telephone | 865-690-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7674
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License Number State | TN
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