# MARTIN G. TILLEY D.D.S., M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARTIN G. TILLEY D.D.S., M.D., P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780910026
- **Legal business name:** MARTIN G. TILLEY D.D.S., M.D., P.C.
- **Authorized official:** DR. MARTIN GEORGE TILLEY M.D., D.D.S. P.C. (OWNER)
- **Authorized official phone:** (308) 865-2577

## Contact information

- **Practice address:** 516 W 39TH ST, SUITE D TOWER PLAZA, KEARNEY, NE 68845-2881
- **Practice address phone:** (308) 865-2577
- **Mailing address:** 516 W 39TH ST, SUITE D TOWER PLAZA, KEARNEY, NE 68845-2881
- **Mailing address phone:** (308) 865-2577

## Taxonomy

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

## Other

- **Enumeration date:** 10/21/2009
- **Last updated:** 01/03/2018