Healthcare Provider Details

I. General information

NPI: 1770676348
Provider Name (Legal Business Name): FRANK NMN MARTINEZ D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. FRANK NMN MARTINEZ

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 SCOTT BLVD
SANTA CLARA CA
95050-4517
US

IV. Provider business mailing address

PO BOX 2767
SARATOGA CA
95070-0767
US

V. Phone/Fax

Practice location:
  • Phone: 408-246-0300
  • Fax:
Mailing address:
  • Phone: 408-279-6540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number27336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: