Provider Demographics
NPI:1710988324
Name:MARTONE, CHRISTOPHER HENRY (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HENRY
Last Name:MARTONE
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 1:1625 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2137
Mailing Address - Country:US
Mailing Address - Phone:724-224-7888
Mailing Address - Fax:724-224-8602
Practice Address - Street 1:1625 UNION AVE
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2137
Practice Address - Country:US
Practice Address - Phone:724-224-7888
Practice Address - Fax:724-224-8602
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-04
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
PADS025262L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01108573Medicaid
PA01108573Medicaid