Averill, Martin E.

Averill, Martin E. is an sole proprietor health care provider with primary practice located at 2102 Kimball Ave , Waterloo IA 50702-5037. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Averill, Martin E. can be contacted via phone (319) 233-3506.

Contact Information

Primary practice address
2102 Kimball Ave Waterloo IA 50702-5037
Phone: (319) 233-3506
Fax: (319) 233-1335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6316 Iowa

Profile Details

NPI number 1043363757
LBN Legal business name Averill, Martin E.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2007
Last updated Jul 8th, 2007 - about 19 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 1043363757 NPPES
Iowa MEDICAID 0004572

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