Provider Demographics
NPI:1760569073
Name:ROBERT A. MARTI, D.D.S., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT A. MARTI, D.D.S., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-227-4476
Mailing Address - Street 1:917 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OK
Mailing Address - Zip Code:73737-1005
Mailing Address - Country:US
Mailing Address - Phone:580-227-4476
Mailing Address - Fax:580-227-3931
Practice Address - Street 1:917 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:OK
Practice Address - Zip Code:73737-1005
Practice Address - Country:US
Practice Address - Phone:580-227-4476
Practice Address - Fax:580-227-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty