Provider Demographics
NPI:1194492413
Name:MARTIN NUNES DMD PLLC
Entity type:Organization
Organization Name:MARTIN NUNES DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-745-7745
Mailing Address - Street 1:188 W PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2228
Mailing Address - Country:US
Mailing Address - Phone:972-745-7745
Mailing Address - Fax:972-745-3166
Practice Address - Street 1:188 W PARKWAY BLVD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2228
Practice Address - Country:US
Practice Address - Phone:972-745-7745
Practice Address - Fax:972-745-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental