Provider Demographics
NPI:1154456051
Name:MARTINA PARRONE DDS
Entity Type:Organization
Organization Name:MARTINA PARRONE DDS
Other - Org Name:AVOID URBAN DECAY THE DENTAL PRACTICE OF DR. MARTINA PARRONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:PARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-702-4204
Mailing Address - Street 1:715 J ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7135
Mailing Address - Country:US
Mailing Address - Phone:619-702-4204
Mailing Address - Fax:
Practice Address - Street 1:715 J ST STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-7135
Practice Address - Country:US
Practice Address - Phone:619-702-4204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty