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General NPI Number Information
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NPI Number | 1861907305
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Entity Type | Organization
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Legal Business Name | MARTIN DOWNS DENTAL CARE, PLLC
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 01/02/2018
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Provider Practice Location Address
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Address Line | 2688 SW IMMANUEL DR
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City | PALM CITY
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State | FL
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Zip | 34990-2738
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Country | US
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Telephone | 772-286-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 2688 SW IMMANUEL DR
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City | PALM CITY
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State | FL
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Zip | 34990-2738
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Country | US
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Telephone | 772-286-8600
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. THOMAS JONES
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Credential | DDS
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Telephone | 772-286-8600
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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 | FL
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