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Organization
MARTIN KIDS DENTAL HEALTH TEAM
Active
Organization
MARTIN KIDS DENTAL HEALTH TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM B MARTIN (OWNER)
(352) 371-3200
Entity
Organization
Contact information
Practice address
13820 W NEWBERRY RD STE 100, JONESVILLE, FL 32669
(352) 371-3200
(352) 377-7102
Mailing address
13820 W NEWBERRY RD STE 100, JONESVILLE, FL 32669-2093
(352) 371-3200
(352) 377-7102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20184
FL
1223P0221X
Pediatric Dentistry
19462
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN7298
FL
Other
Enumeration date
08/08/2013
Last updated
07/23/2018
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