Provider Demographics
NPI:1942342753
Name:MARTINEZ HOPPE, BLANCA (DMD)
Entity Type:Individual
Prefix:DR
First Name:BLANCA
Middle Name:
Last Name:MARTINEZ HOPPE
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 1:4776 HODGES BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7217
Mailing Address - Country:US
Mailing Address - Phone:904-992-0922
Mailing Address - Fax:904-992-0912
Practice Address - Street 1:4776 HODGES BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7217
Practice Address - Country:US
Practice Address - Phone:904-992-0922
Practice Address - Fax:904-992-0912
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14760122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist