Provider Demographics
NPI:1912741026
Name:MARTINEZ, ALINA GISELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALINA
Middle Name:GISELLE
Last Name:MARTINEZ
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 1:106 SEA GRAPE LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78578-2925
Mailing Address - Country:US
Mailing Address - Phone:707-227-4967
Mailing Address - Fax:
Practice Address - Street 1:1141 W US HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4397
Practice Address - Country:US
Practice Address - Phone:956-413-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist