Individual
BRENDA LEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
201 E STRONG ST, SUITE 4, WHEELING, IL 60090-2979
(847) 947-2651
Mailing address
201 E STRONG ST, SUITE 4, WHEELING, IL 60090-2979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030645
IL
Other
Enumeration date
06/20/2016
Last updated
06/21/2016
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