Most Relevant Information
Provider Data
| NPI Number: | 1003363243 |
| Provider Name: | JUAN GERARDO MARTINEZ DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2016 |
| Last Updated: | 10/19/2020 |
Provider Practice Location
490 N MAIN ST STE 207
CORONA
CA
928783461
Practice Location Phone/Fax
| Phone: | 9514447010 |
| Fax: | 9514447181 |
Provider Mailing Location
2919 WILLOW RD
SAN PABLO
CA
948063723
Provider Mailing Phone/Fax
| Phone: | 5106971029 |
| Fax: |