Provider Demographics
NPI:1497949093
Name:MARTIN, TRUMAN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRUMAN
Middle Name:L
Last Name:MARTIN
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 1:3740 SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1630
Mailing Address - Country:US
Mailing Address - Phone:937-278-9126
Mailing Address - Fax:937-278-5908
Practice Address - Street 1:3740 SALEM AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1630
Practice Address - Country:US
Practice Address - Phone:937-278-9126
Practice Address - Fax:937-278-5908
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist