Organization
MARTIN PEDIATRIC DENTISTRY, LLC
Active
Other names
Mighty Mouths
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TU-WANDA MARABLE MARTIN (OWNER/DENTIST)
(864) 627-0029
Entity
Organization
Contact information
Practice address
218 NEW NEELY FERRY RD, MAULDIN, SC 29662-2615
(864) 627-0029
Mailing address
PO BOX 962, MAULDIN, SC 29662-0962
(864) 627-0029
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
687
SC
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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