Provider Demographics
NPI:1104030014
Name:AHRENS, MARTIN G
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:G
Last Name:AHRENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MAIN ST
Mailing Address - Street 2:BOX 216
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1028
Mailing Address - Country:US
Mailing Address - Phone:712-655-2385
Mailing Address - Fax:
Practice Address - Street 1:215 MAIN ST
Practice Address - Street 2:BOX 216
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1028
Practice Address - Country:US
Practice Address - Phone:712-655-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA60481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice