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General NPI Number Information
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NPI Number | 1881730844
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Entity Type | Organization
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Legal Business Name | DRS MARTIN & KIRK PLLC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3659 TEAYS VALLEY ROAD SUITE 100
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City | HURRICANE
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State | WV
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Zip | 25526-9701
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Country | US
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Telephone | 304-201-8500
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Fax | 304-201-8505
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Provider Business Mailing Address
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Address Line | PO BOX 581
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City | HURRICANE
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State | WV
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Zip | 25526-0581
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Country | US
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Telephone | 304-201-8500
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Fax | 304-201-8505
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | JOHN PATRICK MARTIN
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Credential | DDS
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Telephone | 304-201-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | WV3568
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License Number State | WV
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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 | WV3264
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License Number State | WV
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