Individual
KELLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 OLD CHEROKEE RD, SUITE F, PMB 14, LEXINGTON, SC 29072-9316
(803) 808-2304
Mailing address
100 OLD CHEROKEE RD, SUITE F, PMB 14, LEXINGTON, SC 29072-9316
(803) 808-2304
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2601
SC
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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