Provider Demographics
NPI:1306935515
Name:MARTINEZ-AMORES, JENNIFER M (DMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:MARTINEZ-AMORES
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 1:8587 SW 214TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7340
Mailing Address - Country:US
Mailing Address - Phone:305-401-7118
Mailing Address - Fax:
Practice Address - Street 1:13617 S DIXIE HWY
Practice Address - Street 2:SUITE 126
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7259
Practice Address - Country:US
Practice Address - Phone:305-238-1391
Practice Address - Fax:305-238-1635
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL165701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice