Provider Demographics
NPI:1386835239
Name:MARTIN, RACHAEL ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2769
Mailing Address - Country:US
Mailing Address - Phone:515-321-3725
Mailing Address - Fax:
Practice Address - Street 1:1751 E 54TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2769
Practice Address - Country:US
Practice Address - Phone:563-271-8643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice