Provider Demographics
NPI:1285346338
Name:DAVID M MARTINEZ
Entity type:Organization
Organization Name:DAVID M MARTINEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-385-8110
Mailing Address - Street 1:2250 MCGREGOR BLVD APT 1101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3447
Mailing Address - Country:US
Mailing Address - Phone:786-385-8110
Mailing Address - Fax:
Practice Address - Street 1:2023 ALTAMONT AVE STE 108
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3280
Practice Address - Country:US
Practice Address - Phone:786-385-8110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental