Individual
DR. EDWARD JAMES MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1302 PEARL ST, COVINGTON, IN 47932
(765) 793-4680
(765) 793-0513
Mailing address
1302 PEARL ST, COVINGTON, IN 47932
(765) 793-4680
(765) 793-0513
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12006965
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001169900
—
IN
Enumeration date
04/12/2006
Last updated
07/08/2007
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