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General NPI Number Information
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NPI Number | 1841024742
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Entity Type | Organization
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Legal Business Name | JEREMY MARTENS DMD PLLC
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 1706 W MAIN ST STE 117
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City | BATTLE GROUND
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State | WA
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Zip | 98604-4320
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Country | US
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Telephone | 360-726-2762
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Fax |
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Provider Business Mailing Address
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Address Line | 313 NW 106TH ST
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City | VANCOUVER
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State | WA
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Zip | 98685-4317
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Country | US
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Telephone | 707-326-9465
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JEREMY MARTENS
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Credential | DMD
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Telephone | 360-726-2762
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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 |
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License Number State |
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