Provider Demographics
NPI:1326705021
Name:ANGELA MARTEENY PLLC
Entity Type:Organization
Organization Name:ANGELA MARTEENY PLLC
Other - Org Name:MAGNOLIA FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MARTEENY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-813-4239
Mailing Address - Street 1:535 TOVREA RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-2976
Mailing Address - Country:US
Mailing Address - Phone:281-813-4239
Mailing Address - Fax:
Practice Address - Street 1:535 TOVREA RD STE 104
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2976
Practice Address - Country:US
Practice Address - Phone:281-813-4239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty