Martin, Andrea

Martin, Andrea is an sole proprietor health care provider with primary practice located at 330 Court St , Eagle River WI 54521-8362. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Martin, Andrea can be contacted via phone (715) 479-3656.

Contact Information

Primary practice address
330 Court St Eagle River WI 54521-8362
Phone: (715) 479-3656
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 6480-16 Wisconsin

Profile Details

NPI number 1386057099
LBN Legal business name Martin, Andrea
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2014
Last updated Sep 21st, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386057099 NPPES
Wisconsin MEDICAID 1427347426

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