Individual
BROOKE ANDREA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 CLUB MANOR DR STE 202, PUEBLO, CO 81008-1659
(719) 766-9020
Mailing address
24 CLUB MANOR DR STE 202, PUEBLO, CO 81008-1659
(719) 766-9020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204389
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/28/2020
Last updated
08/02/2021
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