Individual
DAVID R MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1418 W 25TH ST, SAN PEDRO, CA 90732-4418
(310) 547-4413
(310) 547-1443
Mailing address
1418 W 25TH ST, SAN PEDRO, CA 90732-4418
(310) 547-4413
(310) 547-1443
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
782565
UNITED CONCORDIA
CA
01
—
B24141-01
DENTI-CAL
CA
Enumeration date
11/29/2006
Last updated
07/08/2007
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