Provider Demographics
NPI:1396035507
Name:MARTIN, HUNTER J (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:J
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 5TH AVE RM 709
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2211
Mailing Address - Country:US
Mailing Address - Phone:212-629-3223
Mailing Address - Fax:212-629-3466
Practice Address - Street 1:366 5TH AVE RM 709
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2211
Practice Address - Country:US
Practice Address - Phone:212-629-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0592081223S0112X
NY287603204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery