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Individual

DR. DEREK MICHAEL MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1259 HYDE PARK AVE, HYDE PARK, MA 02136-2817
(617) 364-5500
Mailing address
1259 HYDE PARK AVE, HYDE PARK, MA 02136-2817
(508) 579-8698

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855962
MA

Other

Enumeration date
06/04/2012
Last updated
06/04/2012
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