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General NPI Number Information
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NPI Number | 1902007701
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Entity Type | Individual
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Provider Name | MARTHA HOPE YOUNGER D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 220 ALABAMA ST
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City | COLUMBUS
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State | MS
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Zip | 39702-5204
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Country | US
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Telephone | 662-328-5197
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Fax | 662-327-5174
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Provider Business Mailing Address
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Address Line | 2005 CHOCTAW RD
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City | COLUMBUS
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State | MS
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Zip | 39705-1434
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Country | US
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Telephone | 662-242-5797
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Fax | 662-327-5174
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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 | 3160-00
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License Number State | MS
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