Provider Demographics
NPI:1073525648
Name:CLOIN, MARTY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTY
Middle Name:L
Last Name:CLOIN
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 1:3703 W GREEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3328
Mailing Address - Country:US
Mailing Address - Phone:817-457-6656
Mailing Address - Fax:817-457-8191
Practice Address - Street 1:3703 W GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-3328
Practice Address - Country:US
Practice Address - Phone:817-457-6656
Practice Address - Fax:817-457-8191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice