Individual
DR. LAURA T MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS ORTHODONTIST
Contact information
Practice address
3240 CORLEAR AVE, BRONX, NY 10463
(718) 601-3910
(718) 432-7103
Mailing address
3240 CORLEAR AVE, BRONX, NY 10463
(718) 601-3910
(718) 432-7103
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0391821
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00919860
—
NY
Enumeration date
01/10/2006
Last updated
07/08/2007
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