Individual
DR. TARAS MARTYNIOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7085
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7085
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.030683
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019.030683
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
108875
CA
Other
Enumeration date
09/01/2016
Last updated
07/02/2024
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