| Martin, Dds Pllc | |
|
140 7th Ave South Charlestown WV 25303 | |
| (304) 342-4422 | |
| (304) 400-4986 |
| Full Name | Martin, Dds Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 140 7th Ave, South Charlestown, West Virginia |
| Authorized Official Name and Position | Jarrel R Martin (MEMBER/OWNER) |
| Authorized Official Contact | 3044190125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin, Dds Pllc 140 7th Ave South Charlestown WV 25303 Ph: (304) 342-4422 | Martin, Dds Pllc 140 7th Ave South Charlestown WV 25303 Ph: (304) 342-4422 |
| NPI Number | 1760810444 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 06/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760810444 | NPI | - | NPPES |
| 3810000582 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3945 (West Virginia) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 3827 (West Virginia) | Primary |