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General NPI Number Information
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NPI Number | 1831127331
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Entity Type | Individual
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Provider Name | ANTHONY ANDREW MARTIN DMD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 248 N PETERS RD SUITE 2
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City | KNOXVILLE
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State | TN
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Zip | 37923-4925
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Country | US
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Telephone | 865-690-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 161 CAPITAL DR 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-3454
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Country | US
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Telephone | 865-690-6691
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS0000007674
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License Number State | TN
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