Provider Demographics
NPI:1396769311
Name:KAHN, MARTIN J (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:KAHN
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 1:3500 INTERSTATE HWY 30
Mailing Address - Street 2:SUITE D-202
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2652
Mailing Address - Country:US
Mailing Address - Phone:972-270-2220
Mailing Address - Fax:972-270-9939
Practice Address - Street 1:3500 INTERSTATE HWY 30
Practice Address - Street 2:SUITE D-202
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2652
Practice Address - Country:US
Practice Address - Phone:972-270-2220
Practice Address - Fax:972-270-9939
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice