Individual
DR. CARLOS A MARTINOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11349 TARA BLVD, HAMPTON, GA 30228-6261
(770) 472-4415
(770) 472-4590
Mailing address
11349 TARA BLVD, HAMPTON, GA 30228-6261
(770) 472-4415
(770) 472-4590
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012501
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351027353H
—
GA
Enumeration date
11/09/2006
Last updated
07/09/2007
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