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General NPI Number Information
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NPI Number | 1760590509
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Entity Type | Individual
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Provider Name | CORWIN DEAN MARTIN MD DDS
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 9450 E IRONWOOD SQUARE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4570
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Country | US
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Telephone | 480-551-0581
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Fax | 480-551-0585
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Provider Business Mailing Address
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Address Line | 9450 E IRONWOOD SQUARE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4570
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Country | US
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Telephone | 480-551-0581
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Fax | 480-551-0585
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D5182
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 29085
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | D05182
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 18135
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | L0398
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License Number State | TX
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