# MARTIN R PITTMAN DDS MS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104812213
- **Authorized official:** MARTIN R PITTMAN DDS (PRESIDENT)
- **Authorized official phone:** (423) 929-8011

## Contact information

- **Practice address:** 111 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5632
- **Practice address phone:** (423) 929-8011
- **Practice address fax:** (429) 929-7811
- **Mailing address:** 111 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D52049 | TN | Yes |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 08/22/2020