Healthcare Provider Details

I. General information

NPI: 1518951789
Provider Name (Legal Business Name): NORMA M MARTINEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CARR 140
BARCELONETA PR
00617-2806
US

IV. Provider business mailing address

9 CARR 140
BARCELONETA PR
00617-2806
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-6178
  • Fax: 787-846-6178
Mailing address:
  • Phone: 787-846-6178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1582
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: