Search › Wisconsin › 122300000X
Ivan Martino, D.D.S
NPI 1487046991 · on the registry since 2015 · sole proprietor
Practice
- Address
- 10347 77th St
Suite 630
Pleasant Prairie, WI 53158 - Phone
- (262) 694-6360
- Organisation at this address
- National Vision Inc
Affordable Dentures & Implants - Kenosha Iii, S.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 122300000X
- Licence states on file
- IL, WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-04-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin