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General NPI Number Information
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NPI Number | 1487705307
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Entity Type | Individual
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Provider Name | PEDRO JAVIER MARTINEZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 8532 OLD CR 54 GREENBROOK PLAZA
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653
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Country | US
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Telephone | 727-372-9669
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Fax | 727-372-5022
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Provider Business Mailing Address
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Address Line | 1320 LAKE POLO DR
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City | ODESSA
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State | FL
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Zip | 33556-1700
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Country | US
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Telephone | 813-785-9807
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Fax | 727-372-5022
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN16023
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License Number State | FL
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