Provider Demographics
NPI:1871768184
Name:SEAN M. MARTIN D.M.D, PA.
Entity type:Organization
Organization Name:SEAN M. MARTIN D.M.D, PA.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-775-3531
Mailing Address - Street 1:608 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON BY THE SEA
Mailing Address - State:NJ
Mailing Address - Zip Code:07717-1020
Mailing Address - Country:US
Mailing Address - Phone:732-775-3231
Mailing Address - Fax:732-775-0074
Practice Address - Street 1:608 MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-1020
Practice Address - Country:US
Practice Address - Phone:732-775-3231
Practice Address - Fax:732-775-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty