Individual
DR. TROY HAROLD MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
207 SPARKS AVE, SUITE 205, JEFFERSONVILLE, IN 47130-3739
(812) 282-8467
(812) 282-3067
Mailing address
207 SPARKS AVE, SUITE 205, JEFFERSONVILLE, IN 47130-3739
(812) 282-8467
(812) 282-3067
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
12006060
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226448
BLUECROSSBLUESHIELD
IN
01
—
61-0702891-002
TID
IN
Enumeration date
05/04/2006
Last updated
07/08/2007
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