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Organization

US NAVY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RODNEY MARTIN DMD (DENTAL OFFICER)
(901) 734-3785
Entity
Organization

Contact information

Practice address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-5419
Mailing address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-3213

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN05164
GA

Other

Enumeration date
09/06/2016
Last updated
09/06/2016
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