OrganizationActive
Crystal Martin DDS LLC
NPI 1609455633 · General Practice Dentistry · Ellisville, MO
Provider details
- NPI number
- 1609455633
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Crystal Martin, Dentist/Owner(636) 227-0507
Specialties & taxonomies
Dental Providers
Practice location
277 Clarkson Rd Ste 100
Ellisville, MO 63011-2280
Phone: (636) 227-0507
Fax: (636) 591-0032
Approximate (ZIP-level) locationGet directions
Mailing address
331 Portico Ct
Chesterfield, MO 63017-2536
Registry dates
- Enumerated
- 2021-04-06
- Last updated
- 2021-06-03
- Certified
- 2021-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.