Provider Demographics
NPI:1437270667
Name:MARTINEZ, ROLANDO M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:M
Last Name:MARTINEZ
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 1:1020 DENNISON AVE
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3497
Mailing Address - Country:US
Mailing Address - Phone:614-298-1543
Mailing Address - Fax:614-298-1632
Practice Address - Street 1:1020 DENNISON AVE
Practice Address - Street 2:SUITE # 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3497
Practice Address - Country:US
Practice Address - Phone:614-298-1543
Practice Address - Fax:614-298-1632
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300202641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice