Individual
MARIA H. MARTINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
112 CLIFFORD AVE, SYLVANIA, GA 30467-2012
(912) 564-7107
Mailing address
611 S MAIN ST, SYLVANIA, GA 30467-2229
(912) 564-2263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00590543A
—
GA
Enumeration date
08/05/2006
Last updated
07/08/2007
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