Individual
MARTY J ESPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
3617 W ARROWHEAD RD, DULUTH, MN 55811-4046
(218) 722-8377
(218) 722-3117
Mailing address
3617 W ARROWHEAD RD, DULUTH, MN 55811-4046
(218) 722-8377
(218) 722-3117
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11100
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5006
WI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
40391
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33751200
WISCONSIN MEDICAID
WI
01
—
49Q57ES
MINNESOTA BCBS
MN
05
—
749215400
—
MN
Enumeration date
01/10/2007
Last updated
12/20/2013
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