Provider Demographics
NPI:1801672621
Name:PEREZ CANALS, MARTA MARIA (DMD)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:MARIA
Last Name:PEREZ CANALS
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 1:6543 BEACON DR
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2983
Mailing Address - Country:US
Mailing Address - Phone:787-688-7780
Mailing Address - Fax:
Practice Address - Street 1:6320 SUGARLOAF PKWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4334
Practice Address - Country:US
Practice Address - Phone:770-381-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1232201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics