Individual
TODD C MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
613 SOUTHWIND DR UNIT 102, LAKE GENEVA, WI 53147-4740
(630) 215-8686
Mailing address
613 SOUTHWIND DR UNIT 102, LAKE GENEVA, WI 53147-4740
(630) 215-8686
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022548
IL
122300000X
Dentist
Primary
6358-15
WI
Other
Enumeration date
09/02/2006
Last updated
04/08/2026
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