Provider Demographics
NPI:1134261399
Name:NETZLER, MARTHA J (DMD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:J
Last Name:NETZLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 CASSIDY CT # A
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4641
Mailing Address - Country:US
Mailing Address - Phone:843-795-1111
Mailing Address - Fax:843-795-8275
Practice Address - Street 1:531 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3007
Practice Address - Country:US
Practice Address - Phone:843-795-1111
Practice Address - Fax:843-795-8275
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist