Organization
DRS WILSON AND MARTINO OF TEAYS VALLEY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT V MARTINO DDS (CEO)
(304) 624-5250
Entity
Organization
Contact information
Practice address
4113 TEAYS VALLEY RD, SCOTT DEPOT, WV 25560-9740
(304) 201-7645
(304) 757-3840
Mailing address
516 COST AVE, STONEWOOD, WV 26301-4811
(304) 624-5250
(304) 624-5251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3070
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810001573
WV DENTAL MEDICAL CARD
WV
Enumeration date
10/02/2006
Last updated
08/22/2020
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