Provider Demographics
NPI:1841204203
Name:MARTENS, JOANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:
Last Name:MARTENS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 STEPHENSON LN
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-2516
Mailing Address - Country:US
Mailing Address - Phone:608-849-4424
Mailing Address - Fax:608-849-4426
Practice Address - Street 1:1125 STEPHENSON LN
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2516
Practice Address - Country:US
Practice Address - Phone:608-849-4424
Practice Address - Fax:608-849-4426
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist