| Doctor Name: | ROGER PAUL MARTIN |
| NPI Number: | 1346415940 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DENTURIST |
| License Number: | 50011 |
| Business Practice Address: | 38 Moore Street Hartland, ME - 04943 |
| Business Phone Number: | 2079385870 |
| Business Fax Number: | |
| Mailing Address: | 38 Moore Street, HARTLAND |
| State: | ME |
| Postal Code: | 04943 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | 50011 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |