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General NPI Number Information
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NPI Number | 1922802297
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Entity Type | Individual
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Provider Name | ERICK E MARTINEZ MADRID DDS
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Gender | Male
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | AGUAS CALIENTES #1632
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City | CD.JUAREZ
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State | CHIHUAHUA
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Zip | 32599
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Country | MX
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Telephone | 915-215-9491
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Fax |
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Provider Business Mailing Address
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Address Line | 11964 MEDALLA ST
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City | EL PASO
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State | TX
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Zip | 79927
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Country | US
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Telephone | 915-215-9491
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14109747
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License Number State | ZZ
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