Individual
DR. JB MARTIN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
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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