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General NPI Number Information
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NPI Number | 1780881961
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Entity Type | Organization
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Legal Business Name | TIMOTHY S MARTINEZ, PC
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CANNON HILL RD AT RTE. 6
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City | SOUTH WELLFLEET
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State | MA
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Zip | 02663
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Country | US
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Telephone | 508-349-6300
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Fax | 508-349-6385
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Provider Business Mailing Address
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Address Line | PO BOX 700
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City | SOUTH WELLFLEET
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State | MA
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Zip | 02663-0700
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Country | US
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Telephone | 508-349-6300
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Fax | 508-349-6385
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TIMOTHY STEVEN MARTINEZ
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Credential | DMD
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Telephone | 508-349-6300
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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 | 16633
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License Number State | MA
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