Provider Demographics
NPI:1275657975
Name:TENA, MARTHA
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:TENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 SIERRA CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6525
Mailing Address - Country:US
Mailing Address - Phone:626-512-7367
Mailing Address - Fax:
Practice Address - Street 1:6654 ROSEMEAD BLVD
Practice Address - Street 2:T&T DENTAL PRACTICES
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660
Practice Address - Country:US
Practice Address - Phone:562-222-2833
Practice Address - Fax:562-222-2853
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice