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General NPI Number Information
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NPI Number | 1598626053
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Entity Type | Organization
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Legal Business Name | STEPHEN M MARTIN,DMD,PLLC
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Dates
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Enumeration Date | 11/22/2025
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 6440 MAIN ST STE 310
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City | WOODRIDGE
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State | IL
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Zip | 60517-1288
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Country | US
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Telephone | 630-442-0833
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Fax | 630-442-0722
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Provider Business Mailing Address
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Address Line | 6440 MAIN ST STE 310
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City | WOODRIDGE
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State | IL
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Zip | 60517-1288
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Country | US
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Telephone | 630-442-0833
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Fax | 630-442-0722
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. STEPHEN MYCHAEL MARTIN
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Credential | DMD
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Telephone | 708-323-5654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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