Provider Demographics
NPI:1093854440
Name:MARTENEY, STEVE (DDS)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:MARTENEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 SAN DIMAS AVE #D
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773
Mailing Address - Country:US
Mailing Address - Phone:626-331-0779
Mailing Address - Fax:626-967-1153
Practice Address - Street 1:626 S 2ND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3517
Practice Address - Country:US
Practice Address - Phone:626-331-0779
Practice Address - Fax:626-967-1153
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA323581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice