Provider Demographics
NPI:1821106311
Name:MARTINEZ, HAROLD JOSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:JOSE
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 1:3107 HUNGARY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2421
Mailing Address - Country:US
Mailing Address - Phone:804-501-0501
Mailing Address - Fax:804-501-0509
Practice Address - Street 1:4106 E PARHAM RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228
Practice Address - Country:US
Practice Address - Phone:804-501-0501
Practice Address - Fax:804-501-0509
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist