Provider Demographics
NPI:1225197734
Name:WRITER, MARTIN CARL (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CARL
Last Name:WRITER
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S CHAPARRAL CT STE 150
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2284
Mailing Address - Country:US
Mailing Address - Phone:714-637-4200
Mailing Address - Fax:714-637-7092
Practice Address - Street 1:100 S CHAPARRAL CT STE 150
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2284
Practice Address - Country:US
Practice Address - Phone:714-637-4200
Practice Address - Fax:714-637-7092
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375191223G0001X, 1223X0400X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics