Individual
DR. TERESA L. MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4383 RHODES AVE, NEW BOSTON, OH 45662-5532
(740) 456-1100
(740) 456-1036
Mailing address
4383 RHODES AVE, NEW BOSTON, OH 45662-5532
(740) 456-1100
(740) 456-1036
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30020064
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2297554
—
OH
01
—
30020064
OHIO LICENSE NUMBER
OH
Enumeration date
11/08/2006
Last updated
07/08/2007
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