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Individual

TRACEY CURTIS MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2305 BAYVILLE RD, VIRGINIA BEACH, VA 23455-1509
(757) 580-3651
Mailing address
2305 BAYVILLE RD, VIRGINIA BEACH, VA 23455-1509
(757) 580-3651

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402003046
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0402003046
VIRGINIA DEPT. OF HEALTH PROFESSIONS
VA
Enumeration date
09/13/2021
Last updated
09/13/2021
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