Provider Demographics
NPI:1699912865
Name:HOSSAIN, MARTA (DDS)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:HOSSAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13731 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2616
Mailing Address - Country:US
Mailing Address - Phone:954-496-0192
Mailing Address - Fax:786-391-4590
Practice Address - Street 1:27325 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8233
Practice Address - Country:US
Practice Address - Phone:786-601-2644
Practice Address - Fax:786-601-2437
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN182581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice