Provider Demographics
NPI:1366655987
Name:TETTEH-MARTEY, WILLIAM H (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:TETTEH-MARTEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-5638
Mailing Address - Country:US
Mailing Address - Phone:707-442-1775
Mailing Address - Fax:707-444-2821
Practice Address - Street 1:3132 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-5638
Practice Address - Country:US
Practice Address - Phone:707-442-1775
Practice Address - Fax:707-444-2821
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice