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Individual

DR. CHARLES G. MARTIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1810 S MACDILL AVE, SUITE 3, TAMPA, FL 33629-5960
(813) 251-2875
Mailing address
1810 S MACDILL AVE, SUITE 3, TAMPA, FL 33629-5960
(813) 251-2875

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN9115
FL

Other

Enumeration date
10/02/2007
Last updated
10/02/2007
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