Individual
NICOLE ELISA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5555 CONNER ST, DETROIT, MI 48213-3448
(313) 571-2648
Mailing address
15666 ENGLEWOOD AVE, ALLEN PARK, MI 48101-1766
(313) 971-6434
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902014663
MI
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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