Provider Demographics
NPI:1891900841
Name:MARTIN AND MARTIN, DDS, PA
Entity Type:Organization
Organization Name:MARTIN AND MARTIN, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJA
Authorized Official - Middle Name:VUKOJICIC
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-847-0902
Mailing Address - Street 1:3101 EDWARDS MILL RD STE 109
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5303
Mailing Address - Country:US
Mailing Address - Phone:919-571-0222
Mailing Address - Fax:919-571-0221
Practice Address - Street 1:3101 EDWARDS MILL RD STE 109
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5303
Practice Address - Country:US
Practice Address - Phone:919-571-0222
Practice Address - Fax:919-571-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty