Organization
CRYSTAL MARTIN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL LUCILLE MARTIN DDS (OWNER/DENTIST)
(636) 227-0507
Entity
Organization
Contact information
Practice address
277 CLARKSON RD STE 100, ELLISVILLE, MO 63011-2280
(636) 227-0507
(636) 591-0032
Mailing address
277 CLARKSON RD STE 100, ELLISVILLE, MO 63011-2280
(636) 227-0507
(636) 591-0032
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/23/2021
Last updated
05/18/2021
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