Provider Demographics
NPI:1255770244
Name:HA, MARTHA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 FLATIRON MARKETPLACE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8033
Mailing Address - Country:US
Mailing Address - Phone:303-321-3040
Mailing Address - Fax:
Practice Address - Street 1:645 FLATIRON MARKETPLACE DR UNIT A
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021
Practice Address - Country:US
Practice Address - Phone:303-321-3040
Practice Address - Fax:303-321-3040
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-23
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO203114122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist