Individual
KALEB MARTINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15341 W WADDELL RD STE B107, SURPRISE, AZ 85379-5169
(623) 975-3933
Mailing address
1770 E 5625 S STE 2, SOUTH OGDEN, UT 84403-5067
(801) 475-1999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009464
AZ
1223G0001X
General Practice Dentistry
D9464
AZ
Other
Enumeration date
06/10/2016
Last updated
01/11/2021
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