Individual
MARTIN SMALLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3145 GARDEN AVE, FORT SAM HOUSTON, TX 78234-7718
(210) 808-3737
Mailing address
2450 CONNELL RD, FORT SAM HOUSTON, TX 78234-7664
(210) 466-5597
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS040045
PA
1223P0700X
Prosthodontics
Primary
DS040045
PA
Other
Enumeration date
08/01/2014
Last updated
07/05/2023
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