Individual
DR. JB MARTIN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
446 EFFINGHAM ST FL 1, PORTSMOUTH, VA 23704-3464
(757) 224-3006
(757) 234-8891
Mailing address
3120 KILN CREEK PKWY STE P, YORKTOWN, VA 23693-5648
(757) 369-1754
(757) 234-8891
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003366225
UNITED CONCORDIA
—
01
—
003366242
UNITED CONCORDIA
—
05
—
008200025
—
VA
Enumeration date
11/24/2006
Last updated
04/12/2019
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