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Organization

MARTIN, DDS PLLC

Active
Other names
Young Smiles WV
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JARREL R MARTIN II DDS (MEMBER/OWNER)
(304) 419-0125
Entity
Organization

Contact information

Practice address
140 7TH AVE, SOUTH CHARLESTOWN, WV 25303
(304) 342-4422
(304) 400-4986
Mailing address
140 7TH AVE, SOUTH CHARLESTOWN, WV 25303
(304) 342-4422
(304) 400-4986

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
3945
WV
1223P0221X
Pediatric Dentistry
Primary
3827
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810000582
WV
Enumeration date
10/16/2013
Last updated
06/17/2020
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