M.d.m. of Ellenton P.a.

NPI #1558779918 in Ellenton, Florida

Provider Information

NPI Number
1558779918
Entity Type
Organization
Organization Name
M.d.m. of Ellenton P.a.
Primary Specialty
Dentist
Enumeration Date
Jul 30, 2014
Last Updated
Jul 30, 2014

Practice Location

Address
5975 FACTORY SHOPS BLVD
State
Florida
ZIP Code
34222-4125
Phone
(941) 254-2300

Authorized Official

Name
DR. JEFFREY MARTIN, DMD
Title
PRESIDENT
Phone
(941) 254-2300

Specialties & Taxonomy Codes

Specialty
Dentist

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