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General NPI Number Information
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NPI Number | 1447378336
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Entity Type | Organization
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Legal Business Name | ED MARTINEZ, DDS, MS, PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1002 N CHURCH ST SUITE 206
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City | GREENSBORO
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State | NC
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Zip | 27401-1439
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Country | US
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Telephone | 336-378-9433
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Fax | 336-378-9796
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Provider Business Mailing Address
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Address Line | 1002 N CHURCH ST SUITE 206
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City | GREENSBORO
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State | NC
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Zip | 27401-1439
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Country | US
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Telephone | 336-378-9433
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Fax | 336-378-9796
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ED ISMAEL MARTINEZ
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Credential | DDS, MS
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Telephone | 336-378-9433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 6414
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License Number State | NC
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