Provider Demographics
NPI:1295869659
Name:MARTOWSKI, PHILIP JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JAMES
Last Name:MARTOWSKI
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 1:886 DAHLIA LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-4914
Mailing Address - Country:US
Mailing Address - Phone:772-231-6949
Mailing Address - Fax:772-231-6533
Practice Address - Street 1:886 DAHLIA LN
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-4914
Practice Address - Country:US
Practice Address - Phone:772-231-6949
Practice Address - Fax:772-231-6533
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL146201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice