Provider Demographics
NPI:1316165616
Name:MARTINEZ, JOEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4639
Mailing Address - Country:US
Mailing Address - Phone:956-682-2161
Mailing Address - Fax:956-687-2368
Practice Address - Street 1:600 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4639
Practice Address - Country:US
Practice Address - Phone:956-682-2161
Practice Address - Fax:956-687-2368
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics