Individual
WALTER D MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2205 CENTRAL AVE, KEARNEY, NE 68847-5346
(308) 237-5853
(308) 237-5089
Mailing address
2205 CENTRAL AVE, KEARNEY, NE 68847-5346
(308) 237-5853
(308) 237-5089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5104
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252765-00
—
NE
Enumeration date
04/11/2007
Last updated
07/09/2007
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