Individual
BRENDA LEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030645
IL
122300000X
Dentist
Primary
30.028369
OH
Other
Enumeration date
06/20/2016
Last updated
06/04/2026
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