Organization
LEE J. MARTIN, DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE JOSHUA MARTIN DMD (DENTIST)
(912) 966-2102
Entity
Organization
Contact information
Practice address
109 OGLESBY AVE, GARDEN CITY, GA 31408-1611
(912) 966-2102
(912) 966-2103
Mailing address
109 OGLESBY AVE, GARDEN CITY, GA 31408-1611
(912) 966-2102
(912) 966-2103
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN014447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN014447
DENTAL LICENSE
GA
Enumeration date
11/07/2017
Last updated
11/07/2017
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