Provider Demographics
NPI:1740894658
Name:MARTINEZ MORALES, MARIA VALENTINA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VALENTINA
Last Name:MARTINEZ MORALES
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 1:710 S GOLD AVE
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-4161
Mailing Address - Country:US
Mailing Address - Phone:575-546-1400
Mailing Address - Fax:
Practice Address - Street 1:710 S GOLD AVE
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4161
Practice Address - Country:US
Practice Address - Phone:575-546-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD53211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice