Organization
BROOKSTONE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN W. MARTIN DDS (OWNER)
(423) 247-8172
Entity
Organization
Contact information
Practice address
4260 FORT HENRY DR, STE 13, KINGSPORT, TN 37663-2248
(423) 239-6594
Mailing address
4260 FORT HENRY DR, STE 13, KINGSPORT, TN 37663-2248
(423) 239-6594
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8093
TN
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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