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General NPI Number Information
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NPI Number | 1891808218
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Entity Type | Individual
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Provider Name | ROBERT F MARTIN JR. DMD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 137 INTERSTATE DR
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City | GREENVILLE
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State | AL
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Zip | 36037-3731
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Country | US
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Telephone | 334-382-9610
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Fax | 334-382-2930
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Provider Business Mailing Address
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Address Line | 137 INTERSTATE DR
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City | GREENVILLE
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State | AL
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Zip | 36037-3731
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Country | US
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Telephone | 334-382-9610
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Fax | 334-382-2930
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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 | 3867
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License Number State | AL
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