Provider Demographics
NPI:1962227082
Name:RAMIREZ MARTINEZ, CHRISTIAN ALBERTO (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ALBERTO
Last Name:RAMIREZ 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 1:2026 N IMPERIAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-1607
Mailing Address - Country:US
Mailing Address - Phone:760-339-9992
Mailing Address - Fax:760-353-3635
Practice Address - Street 1:2026 N IMPERIAL AVE STE B
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-1607
Practice Address - Country:US
Practice Address - Phone:760-339-9992
Practice Address - Fax:760-353-3635
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist