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General NPI Number Information
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NPI Number | 1811413297
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Entity Type | Organization
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Legal Business Name | ANDRES K. MARTINEZ, D.D.S., INC.
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 418 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5301
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Country | US
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Telephone | 714-485-4555
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Fax |
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Provider Business Mailing Address
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Address Line | 418 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5301
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Country | US
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Telephone | 714-485-4555
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANDRES MARTINEZ
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Credential | DDS
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Telephone | 714-485-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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