Martin, Mackenzie Kate

Martin, Mackenzie Kate is an individual health care provider with primary practice located at 68 Old Airport Rd , Hattiesburg MS 39401-8382. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Martin, Mackenzie Kate can be contacted via phone (601) 583-4800.

Contact Information

Primary practice address
68 Old Airport Rd Hattiesburg MS 39401-8382
Phone: (601) 583-4800
Fax: (601) 584-7769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4113-20 Mississippi

Profile Details

NPI number 1639737646
LBN Legal business name Martin, Mackenzie Kate
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2019
Last updated Sep 18th, 2020 - about 6 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 1639737646 NPPES
Mississippi MEDICAID 06359830

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