| E. Dale Martin, D.d.s., M.s.d., P.c. | |
|
3904 Boat Club Rd Lake Worth TX 76135-3201 | |
| (817) 238-6450 | |
| (817) 238-6497 |
| Full Name | E. Dale Martin, D.d.s., M.s.d., P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3904 Boat Club Rd, Lake Worth, Texas |
| Authorized Official Name and Position | Eddy Dale Martin (DENTIST) |
| Authorized Official Contact | 8172386450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E. Dale Martin, D.d.s., M.s.d., P.c. 3904 Boat Club Rd Lake Worth TX 76135-3201 Ph: (817) 238-6450 | E. Dale Martin, D.d.s., M.s.d., P.c. 3904 Boat Club Rd Lake Worth TX 76135-3201 Ph: (817) 238-6450 |
| NPI Number | 1689611527 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689611527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 13263 (Texas) | Primary |
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