Individual
KENNETH RANDOLPH MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6 N LEXINGTON AVE, HAVERTOWN, PA 19083-5002
(610) 446-3883
(610) 853-2728
Mailing address
6 N LEXINGTON AVE, HAVERTOWN, PA 19083-5002
(610) 446-3883
(610) 853-2728
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS027161L
PA
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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