Provider Demographics
NPI:1124149240
Name:HALEY, MARTIN CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CHARLES
Last Name:HALEY
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 1:7 CAULK LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3859
Mailing Address - Country:US
Mailing Address - Phone:410-822-2232
Mailing Address - Fax:
Practice Address - Street 1:7 CAULK LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3859
Practice Address - Country:US
Practice Address - Phone:410-822-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6411122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist