Organization
FRIENDLY FACES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JB MARTIN IV (PRESIDENT)
(757) 397-9801
Entity
Organization
Contact information
Practice address
446 EFFINGHAM ST, 1ST FLOOR, PORTSMOUTH, VA 23704-3416
(757) 397-9801
(757) 397-9805
Mailing address
446 EFFINGHAM ST, 1ST FLOOR, PORTSMOUTH, VA 23704-3416
(757) 397-9801
(757) 397-9805
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401007603
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008200025
—
VA
Enumeration date
05/22/2009
Last updated
05/22/2009
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