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Individual

DR. BENJAMIN JOHN MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MS

Contact information

Practice address
220 S DENTON TAP RD, SUITE 203, COPPELL, TX 75019-5038
(972) 393-5550
Mailing address
220 S DENTON TAP RD, SUITE 203, COPPELL, TX 75019-5038
(801) 318-5003

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
29865
TX

Other

Enumeration date
02/11/2013
Last updated
02/20/2015
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