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Individual

DR. RICHARD J MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., D.M.D.

Contact information

Practice address
159 SACHEM ST, NORWICH, CT 06360-4144
(860) 885-0444
Mailing address
159 SACHEM ST, NORWICH, CT 06360-4144

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
007905
CT
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036472
CT

Other

Enumeration date
09/02/2005
Last updated
11/01/2011
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