MEDICARE: DR. TAMARA TATIANA MARTINEZ D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN17684	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881727717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMARA TATIANA MARTINEZ D.D.S

Provider Business Mailing Address
First Line	:	3207 N STATE ROAD 7
Second Line	:	SUITE #24
City	:	MARGATE
State	:	FL
Zip	:	33063-7008
Country	:	US
Telephone Number	:	954-979-1357
Fax Number	:	954-979-0763

Provider Business Practice Location Address
First Line	:	3207 N STATE ROAD 7
Second Line	:	SUITE #24
City	:	MARGATE
State	:	FL
Zip	:	33063-7008
Country	:	US
Telephone Number	:	954-979-1357
Fax Number	:	954-979-0763

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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