Individual
DR. EDDY DALE MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3904 BOAT CLUB RD, LAKE WORTH, TX 76135-3201
(817) 238-6450
(817) 238-6497
Mailing address
3904 BOAT CLUB RD, LAKE WORTH, TX 76135-3201
(817) 238-6450
(817) 238-6497
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13263
TX
Other
Enumeration date
06/10/2006
Last updated
07/08/2007
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