Individual
DR. JASON RICHARD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
409 W LUDINGTON AVE, SUITE 101, LUDINGTON, MI 49431-2377
(231) 845-7240
Mailing address
409 W LUDINGTON AVE, SUITE 101, LUDINGTON, MI 49431-2377
(231) 845-7240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19317
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4926597
—
MI
Enumeration date
11/06/2006
Last updated
07/08/2007
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