# BROOKSTONE DENTAL, PLLC

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

## Provider details

- **NPI number:** 1619351251
- **Authorized official:** KEVIN W. MARTIN DDS (OWNER)
- **Authorized official phone:** (423) 247-8172

## Contact information

- **Practice address:** 4260 FORT HENRY DR, STE 13, KINGSPORT, TN 37663-2248
- **Practice address phone:** (423) 239-6594
- **Mailing address:** 4260 FORT HENRY DR, STE 13, KINGSPORT, TN 37663-2248
- **Mailing address phone:** (423) 239-6594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8093 | TN | Yes |

## Other

- **Enumeration date:** 07/14/2015
- **Last updated:** 07/14/2015