Provider Demographics
NPI:1013352780
Name:MARTINEZ AND ZERMENO III APDC
Entity type:Organization
Organization Name:MARTINEZ AND ZERMENO III APDC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:1951-372-0700
Mailing Address - Street 1:1530 W 6TH ST
Mailing Address - Street 2:SUITE #105
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2742
Mailing Address - Country:US
Mailing Address - Phone:951-372-0707
Mailing Address - Fax:951-372-0707
Practice Address - Street 1:1530 W 6TH ST
Practice Address - Street 2:SUITE #105
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2742
Practice Address - Country:US
Practice Address - Phone:951-372-0707
Practice Address - Fax:951-372-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty