Provider Demographics
NPI:1841528189
Name:MARTINEZ, ZACHARY GAVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:GAVIN
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 TOLLAND STAGE RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2924
Mailing Address - Country:US
Mailing Address - Phone:860-872-8551
Mailing Address - Fax:860-871-8364
Practice Address - Street 1:630 TOLLAND STAGE RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-2924
Practice Address - Country:US
Practice Address - Phone:860-872-8551
Practice Address - Fax:860-871-8364
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT104911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice