Individual
DR. WILLIAM BROCK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1411 23RD AVE, MERIDIAN, MS 39301-4024
(601) 482-5701
(601) 482-8401
Mailing address
1411 23RD AVE, MERIDIAN, MS 39301-4024
(601) 485-5701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3396-06
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3396-06
STATE LICENSE NUMBER
MS
Enumeration date
06/01/2007
Last updated
10/18/2010
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