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NPI 1598105926

NPI 1598105926 : ANDREW S MARTIN DDS : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1598105926
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW S MARTIN DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/29/2013
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    Last Update Date     |    06/29/2013
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Provider Practice Location Address
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    Address Line         |    729 8TH ST SE 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20003-2823
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    Country              |    US
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    Telephone            |    202-546-2202
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1150 RIPLEY ST APT 1204 
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    City                 |    SILVER SPRING
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    State                |    MD
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    Zip                  |    20910-7429
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    DEN1001282
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    License Number State |    DC
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