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General NPI Number Information
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NPI Number | 1114555687
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Entity Type | Individual
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Provider Name | YVETTE ALEXIS MARTINEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 25235 IH 10 W STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78257-2105
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Country | US
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Telephone | 210-879-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 418 GETTYSBURG ST
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City | MESQUITE
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State | TX
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Zip | 75149-4882
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Country | US
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Telephone | 972-322-5378
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 35247
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35247
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License Number State | TX
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