Provider Demographics
NPI:1225675671
Name:DAVID D. MARTINEZ MD, DMD, PA
Entity Type:Organization
Organization Name:DAVID D. MARTINEZ MD, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:480-242-9089
Mailing Address - Street 1:3110 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5020
Mailing Address - Country:US
Mailing Address - Phone:480-242-9089
Mailing Address - Fax:
Practice Address - Street 1:804 GILMER ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4326
Practice Address - Country:US
Practice Address - Phone:480-242-9089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty