Individual
STEPHANIE LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1927 BROAD RIPPLE AVENUE, INDIANAPOLIS, IN 46220
(317) 257-9103
(317) 257-0931
Mailing address
1927 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220
(317) 257-9103
(317) 257-0931
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IN12009976
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200328940
—
IN
Enumeration date
04/02/2007
Last updated
07/08/2007
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