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Organization
ANTHONY C. MARTIN DMD LLC
Active
Organization
ANTHONY C. MARTIN DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY CHARLES MARTIN DMD (PRESIDENT)
(803) 749-6072
Entity
Organization
Contact information
Practice address
111 OBRIAN WAY, IRMO, SC 29063-8776
(803) 749-6072
Mailing address
PO BOX 195, BALLENTINE, SC 29002-0195
(803) 749-6072
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2590
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z2590
—
SC
Enumeration date
12/18/2014
Last updated
12/18/2014
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