Provider Demographics
NPI:1659587525
Name:MARTINEZ, MARCIA ESTELA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:ESTELA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8792
Mailing Address - Country:US
Mailing Address - Phone:407-273-6620
Mailing Address - Fax:407-381-5750
Practice Address - Street 1:5180 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8792
Practice Address - Country:US
Practice Address - Phone:407-273-6620
Practice Address - Fax:407-381-5750
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 154411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice