Provider Demographics
NPI:1033197066
Name:MARTIN, DENNIS C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 NORMAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5562
Mailing Address - Country:US
Mailing Address - Phone:402-488-7020
Mailing Address - Fax:402-488-2017
Practice Address - Street 1:4700 NORMAL BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5562
Practice Address - Country:US
Practice Address - Phone:402-488-7020
Practice Address - Fax:402-488-2017
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE62861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice