Organization
MARTIN KIDS DENTAL HEALTH TEAM OF LAKE CITY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELIA S MARTIN DMD (OWNER)
(386) 752-8200
Entity
Organization
Contact information
Practice address
875 SW STATE ROAD 47, LAKE CITY, FL 32025-0433
(386) 752-8200
Mailing address
875 SW STATE ROAD 47, LAKE CITY, FL 32025-0433
(386) 752-8200
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN19462
FL
Other
Enumeration date
02/07/2014
Last updated
02/07/2014
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