Provider Demographics
NPI:1073815940
Name:MARTIN A. DENBAR, DDS
Entity Type:Organization
Organization Name:MARTIN A. DENBAR, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DENBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-338-8120
Mailing Address - Street 1:7800 N MOPAC EXPY
Mailing Address - Street 2:#300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8900
Mailing Address - Country:US
Mailing Address - Phone:512-338-8120
Mailing Address - Fax:512-338-8192
Practice Address - Street 1:7800 N MOPAC EXPY
Practice Address - Street 2:#300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8900
Practice Address - Country:US
Practice Address - Phone:512-338-8120
Practice Address - Fax:512-338-8192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10699261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6462540001Medicare NSC