Provider Demographics
NPI:1336262666
Name:MENGES, MARTIN J JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:MENGES
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:12528 WARWICK BLVD
Mailing Address - Street 2:ST C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2676
Mailing Address - Country:US
Mailing Address - Phone:757-591-8515
Mailing Address - Fax:757-591-8517
Practice Address - Street 1:12528 WARWICK BLVD
Practice Address - Street 2:ST C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2676
Practice Address - Country:US
Practice Address - Phone:757-591-8515
Practice Address - Fax:757-591-8517
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0401005135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist