Provider Demographics
NPI:1598055063
Name:MARTINEZ, CHRISTOPHER JAVIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAVIER
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10124 N GLASSCOCK RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-5910
Mailing Address - Country:US
Mailing Address - Phone:210-422-1141
Mailing Address - Fax:
Practice Address - Street 1:3509 E MAIN AVE STE 103
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-1562
Practice Address - Country:US
Practice Address - Phone:565-839-6019
Practice Address - Fax:956-583-9603
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice