Individual
DR. MARTIN RUSSELL MINIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
253 HAGER BRANCH, EAST POINT, KY 41216
(606) 886-0808
(606) 886-9584
Mailing address
PO BOX 229, PRESTONSBURG, KY 41653-0229
(606) 886-0808
(606) 886-9584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6678
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60066784
—
KY
Enumeration date
01/24/2007
Last updated
07/08/2007
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