Individual
GRECY ROXANNA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3610 BROADWAY, NEW YORK, NY 10031-3240
(212) 491-6940
Mailing address
3610 BROADWAY, NEW YORK, NY 10031-3240
(212) 491-6940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045036
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01439954
—
NY
Enumeration date
12/06/2006
Last updated
07/08/2007
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