# MARTIN DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARTIN DENTISTRY PC
- **Other names:** Dr. Jack Holly, DDS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730757691
- **Legal business name:** MARTIN DENTISTRY PC
- **Authorized official:** REBECCA ARNOLD (REVENUE MANAGER)
- **Authorized official phone:** (423) 247-8172

## Contact information

- **Practice address:** 417 HUDSON DR, ELIZABETHTON, TN 37643-2881
- **Practice address phone:** (423) 543-4141
- **Mailing address:** 417 HUDSON DR, ELIZABETHTON, TN 37643-2881
- **Mailing address phone:** (423) 543-4141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/16/2021
- **Last updated:** 07/23/2021