Provider Demographics
NPI:1073674073
Name:LESS, MARTIN FREDERICK (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:FREDERICK
Last Name:LESS
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N OAK ST
Mailing Address - Street 2:APT 1421
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3033 WILSON BLVD
Practice Address - Street 2:200A
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3843
Practice Address - Country:US
Practice Address - Phone:703-228-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010045501223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health