Provider Demographics
NPI:1679788095
Name:DENBAR, MARTIN A (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:A
Last Name:DENBAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 N MO PAC EXPY STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8890
Mailing Address - Country:US
Mailing Address - Phone:512-338-8120
Mailing Address - Fax:512-338-8192
Practice Address - Street 1:7800 N MO PAC EXPY STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8890
Practice Address - Country:US
Practice Address - Phone:512-338-8120
Practice Address - Fax:512-338-8192
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist