Individual
KIMBERLY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
705 E UNIVERSITY AVE, STE B, LAS CRUCES, NM 88001-5637
(505) 521-0127
(505) 647-9533
Mailing address
705 E UNIVERSITY AVE, STE B, LAS CRUCES, NM 88001-5637
(505) 521-0127
(505) 647-9533
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2317
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33070270
—
NM
Enumeration date
08/31/2005
Last updated
07/08/2007
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