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General NPI Number Information
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NPI Number | 1841358413
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Entity Type | Individual
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Provider Name | TARIA SHAMONE MARTIN DDS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1243 E RED BIRD LN
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City | DALLAS
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State | TX
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Zip | 75241-2008
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Country | US
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Telephone | 214-372-6062
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Fax | 214-372-9635
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Provider Business Mailing Address
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Address Line | 2914 LARIAT LN
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City | ARLINGTON
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State | TX
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Zip | 76015-2520
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Country | US
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Telephone | 214-693-7958
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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 | 19963
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License Number State | TX
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