Organization
MARTIN FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL JOHN MARTIN DDS (OWNER/OPERATOR)
(636) 343-1550
Entity
Organization
Contact information
Practice address
517 MAIN ST, FENTON, MO 63026-4169
(636) 343-1550
(636) 343-1524
Mailing address
517 MAIN ST, FENTON, MO 63026-4169
(636) 343-1550
(636) 343-1524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010150
MO
Other
Enumeration date
07/11/2006
Last updated
05/16/2008
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