# MARTINEAU DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215489141
- **Authorized official:** BRENT MARTINEAU D.M.D. (OWNER/DENTIST)
- **Authorized official phone:** (623) 975-3933

## Contact information

- **Practice address:** 15341 W WADDELL RD, SUITE B107, SURPRISE, AZ 85379-5169
- **Practice address phone:** (623) 975-3933
- **Practice address fax:** (623) 975-3493
- **Mailing address:** 15341 W WADDELL RD, SUITE B107, SURPRISE, AZ 85379-5169
- **Mailing address phone:** (623) 975-3933
- **Mailing address fax:** (623) 975-3493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D6112 | AZ | Yes |

## Other

- **Enumeration date:** 10/26/2016
- **Last updated:** 10/26/2016