Individual
DR. JARRELL RICHARD MARTIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1218 VIRGINIA ST E, SUITE D, CHARLESTON, WV 25301-2951
(304) 342-4422
Mailing address
1218 VIRGINIA ST E, SUITE D, CHARLESTON, WV 25301-2951
(304) 342-4422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS038966
PA
1223G0001X
General Practice Dentistry
Primary
3945
WV
Other
Enumeration date
05/30/2011
Last updated
02/24/2014
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