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Individual

DR. JACOB DAVID MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1851 COUNTY ROAD XX, KRONENWETTER, WI 54455-7933
(715) 359-0550
Mailing address
820 GLADE CT APT 11, KRONENWETTER, WI 54455-7333
(423) 710-6078

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001570-15
WI

Other

Enumeration date
05/22/2023
Last updated
07/22/2024
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