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General NPI Number Information
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NPI Number | 1639596463
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Entity Type | Individual
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Provider Name | DANIEL MARTIR DMD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 549 CALLE LAS CAISEAS
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City | MAYAGUEZ
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State | PR
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Zip | 00682-5965
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Country | US
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Telephone | 787-319-8061
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Fax |
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Provider Business Mailing Address
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Address Line | 8350 TAVERN PT
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City | SAN ANTONIO
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State | TX
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Zip | 78254-5579
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Country | US
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Telephone | 787-319-8061
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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 | 3165
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33738
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License Number State | TX
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