Provider Demographics
NPI:1437217650
Name:KIRKLAND, MARTHA VIRGINIA (DMD MS)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:VIRGINIA
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:VIRGINIA
Other - Last Name:KIRKLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4205 NORTH POINT PARKWAY
Mailing Address - Street 2:BUILDING A
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:770-740-0442
Mailing Address - Fax:770-740-9830
Practice Address - Street 1:4205 NORTH POINT PARKWAY
Practice Address - Street 2:BUILDING A
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:770-740-0442
Practice Address - Fax:770-740-9830
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011812122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist