# MARTIN ORAL AND MAXILLOFACIAL SURGERY, PA

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

## Provider details

- **NPI number:** 1538499041
- **Authorized official:** DR. ROBERT ANDREW MARTIN D.M.D., M.D. (OWNER)
- **Authorized official phone:** (662) 323-3801

## Contact information

- **Practice address:** 101 WALKER WAY, STARKVILLE, MS 39759
- **Practice address phone:** (662) 323-3801
- **Practice address fax:** (662) 323-3121
- **Mailing address:** PO BOX 770, STARKVILLE, MS 39760-0770
- **Mailing address phone:** (662) 323-3801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 352809 | MS | Yes |

## Other

- **Enumeration date:** 01/05/2010
- **Last updated:** 01/07/2016