Healthcare Provider Details

I. General information

NPI: 1245966738
Provider Name (Legal Business Name): ANAMARIE CRUZ MARTINEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 02/07/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE LAS AMERICAS 2105, PLAZOLETA LAS AMERICAS
PONCE PR
00733
US

IV. Provider business mailing address

URB PASEO REAL 161 CALLE CONSULADO
COAMO PR
00769
US

V. Phone/Fax

Practice location:
  • Phone: 787-842-8945
  • Fax:
Mailing address:
  • Phone: 787-486-7027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3425
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: