Most Relevant Information
Provider Data
| NPI Number: | 1003265158 |
| Provider Name: | EDWIN MARTINEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2016 |
| Last Updated: | 06/09/2016 |
Provider Practice Location
1061 HARMON AVE
FORT STEWART
GA
313145641
Practice Location Phone/Fax
| Phone: | 9127676174 |
| Fax: |
Provider Mailing Location
1061 HARMON AVE
FORT STEWART
GA
313145641
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |