Individual
DR. AVERY MAKENZIE LANE MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
703 N CASCADE AVE, COLORADO SPRINGS, CO 80903-3206
(719) 633-0999
Mailing address
703 N CASCADE AVE, COLORADO SPRINGS, CO 80903-3206
(719) 633-0999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27982
FL
122300000X
Dentist
Primary
MSDEN.00000008
CO
Other
Enumeration date
03/28/2023
Last updated
12/04/2024
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