Individual
MARTIN G MARTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S,
Contact information
Practice address
10833 LE CONTE AVE., UCLA DEPARTMENT OF ORTHODONTICS MD 12-334, LOS ANGELES, CA 90095-1752
(310) 825-5161
(310) 206-4921
Mailing address
10833 LE CONTE AVE., UCLA DEPARTMENT OF ORTHODONTICS MD 12-334, LOS ANGELES, CA 90095-1752
(310) 825-5651
(310) 206-4921
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
26203
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CGP163017
—
CA
Enumeration date
11/10/2008
Last updated
03/29/2016
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