Individual
DR. TOMMY R MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
650 CHESTNUT ST # 2, HICKMAN, NE 68372-9764
(402) 792-3000
(402) 792-3500
Mailing address
650 CHESTNUT ST # 2, HICKMAN, NE 68372-9764
(402) 792-3000
(402) 792-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4945
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025549700
—
NE
01
—
4945
LICENSE
NE
Enumeration date
01/18/2007
Last updated
05/03/2012
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