Provider Demographics
NPI:1649374158
Name:MARTY, EMILIO NAVAL (DMD)
Entity type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:NAVAL
Last Name:MARTY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:EMILIO
Other - Middle Name:NAVAL
Other - Last Name:MARTY LARACUENTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:324 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4932
Mailing Address - Country:US
Mailing Address - Phone:252-522-9800
Mailing Address - Fax:252-523-9790
Practice Address - Street 1:324 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-522-9800
Practice Address - Fax:252-523-9790
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1700122300000X
NC109181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist