Provider Demographics
NPI:1306193768
Name:MARTIN & MUNOZ, D.D.S., INC.
Entity Type:Organization
Organization Name:MARTIN & MUNOZ, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ESMERALDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-372-7548
Mailing Address - Street 1:85 VIA ROBLES
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6113
Mailing Address - Country:US
Mailing Address - Phone:831-372-7548
Mailing Address - Fax:831-372-8908
Practice Address - Street 1:85 VIA ROBLES
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6113
Practice Address - Country:US
Practice Address - Phone:831-372-7548
Practice Address - Fax:831-372-8908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-04
Last Update Date:2012-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577101223G0001X
CA576721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty