Provider Demographics
NPI:1306882535
Name:DIAMOND, MARTIN JOEL (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JOEL
Last Name:DIAMOND
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 1:22815 SAM SNEAD HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6084 SAM SNEAD HIGHWAY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:24445
Practice Address - Country:US
Practice Address - Phone:540-839-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA8232122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist