Provider Demographics
NPI:1477701704
Name:MARTORANA, JOSEPH (DDS PC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:MARTORANA
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 W HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-2011
Mailing Address - Country:US
Mailing Address - Phone:773-774-2114
Mailing Address - Fax:
Practice Address - Street 1:6917 W HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-2011
Practice Address - Country:US
Practice Address - Phone:773-774-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-019861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist