Provider Demographics
NPI:1255849014
Name:MARTELL, FRANK (DMD, MPH, MS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:MARTELL
Suffix:
Gender:M
Credentials:DMD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 71 BOX 2926
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-9432
Mailing Address - Country:US
Mailing Address - Phone:787-932-4463
Mailing Address - Fax:
Practice Address - Street 1:4 CARR 165
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2338
Practice Address - Country:US
Practice Address - Phone:787-870-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty