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NPI Code Detail

MEDICARE: MARTIN DENTISTRY PC

MEDICARE: MARTIN DENTISTRY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1285870931
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTIN DENTISTRY PC
Provider Business Mailing Address
First Line : 1599 FORT HENRY DR
Second Line : SUITE 102
City : KINGSPORT
State : TN
Zip : 37664-2535
Country : US
Telephone Number : 423-247-8172
Fax Number : 423-392-8253
Provider Business Practice Location Address
First Line : 1599 FORT HENRY DR
Second Line : SUITE 102
City : KINGSPORT
State : TN
Zip : 37664-2535
Country : US
Telephone Number : 423-247-8172
Fax Number : 423-392-8253
Authorized Official
Title or Position : REVENUE MANAGER
Name : REBECCA ARNOLD
Credential :
Telephone Number : 423-247-8172
Provider Enumeration Date : 12/31/2008
Last Update Date : 07/22/2021

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Directions to “MARTIN DENTISTRY PC ” Practice Location

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