| Anthony C. Martin Dmd Llc | |
|
111 Obrian Way Irmo SC 29063-8776 | |
| (803) 749-6072 | |
| Not Available |
| Full Name | Anthony C. Martin Dmd Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 111 Obrian Way, Irmo, South Carolina |
| Authorized Official Name and Position | Anthony Charles Martin (PRESIDENT) |
| Authorized Official Contact | 8037496072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony C. Martin Dmd Llc Po Box 195 Ballentine SC 29002-0195 Ph: (803) 749-6072 | Anthony C. Martin Dmd Llc 111 Obrian Way Irmo SC 29063-8776 Ph: (803) 749-6072 |
| NPI Number | 1841698149 |
|---|---|
| Provider Enumeration Date | 12/18/2014 |
| Last Update Date | 12/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841698149 | NPI | - | NPPES |
| Z2590 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2590 (South Carolina) | Primary |
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