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General NPI Number Information
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NPI Number | 1871775635
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Entity Type | Individual
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Provider Name | ASHLA MARTIN DDS
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Gender | Female
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 450 N HIGHWAY 67 STE 100
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City | CEDAR HILL
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State | TX
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Zip | 75104-2136
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Country | US
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Telephone | 972-291-5720
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Fax | 972-291-5730
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Provider Business Mailing Address
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Address Line | 450 N HIGHWAY 67 STE 100
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City | CEDAR HILL
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State | TX
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Zip | 75104-2136
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Country | US
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Telephone | 972-291-5720
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Fax | 972-291-5730
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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 | 5873
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25216
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License Number State | TX
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