Provider Demographics
NPI:1205955903
Name:MARGETIS, MARTIN J (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:MARGETIS
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 1:13624 N 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2813
Mailing Address - Country:US
Mailing Address - Phone:623-974-5857
Mailing Address - Fax:623-974-2594
Practice Address - Street 1:13624 N 99TH AVE
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2813
Practice Address - Country:US
Practice Address - Phone:623-974-5857
Practice Address - Fax:623-974-2594
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice