Provider Demographics
NPI:1417139460
Name:OBERMAN, MARTIN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:L
Last Name:OBERMAN
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 1:801 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2024
Mailing Address - Country:US
Mailing Address - Phone:215-659-3334
Mailing Address - Fax:
Practice Address - Street 1:801 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2024
Practice Address - Country:US
Practice Address - Phone:215-659-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018970L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist