Provider Demographics
NPI:1558760892
Name:RIOS AND MARTINEZ DENTAL INC.
Entity Type:Organization
Organization Name:RIOS AND MARTINEZ DENTAL INC.
Other - Org Name:RIO MAR DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIANNA
Authorized Official - Middle Name:GESURI
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-578-6768
Mailing Address - Street 1:431 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1712
Mailing Address - Country:US
Mailing Address - Phone:714-578-6768
Mailing Address - Fax:
Practice Address - Street 1:431 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1712
Practice Address - Country:US
Practice Address - Phone:714-578-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA603171223G0001X
CA612861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty