Provider Demographics
NPI:1962521898
Name:NIETO, MARTA L (MARTA NIETO DDS)
Entity type:Individual
Prefix:DR
First Name:MARTA
Middle Name:L
Last Name:NIETO
Suffix:
Gender:F
Credentials:MARTA NIETO DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SW 87TH AVE
Mailing Address - Street 2:SUITE2700
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3242
Mailing Address - Country:US
Mailing Address - Phone:305-228-9600
Mailing Address - Fax:305-228-9614
Practice Address - Street 1:2710 SW 87TH AVE
Practice Address - Street 2:SUITE2700
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3242
Practice Address - Country:US
Practice Address - Phone:305-228-9600
Practice Address - Fax:305-228-9614
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00131371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice