Individual
DR. RICHARD DALE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2936 HIGHLAND DR STE 101, SLC, UT 84106-3583
(801) 467-6555
(801) 474-0103
Mailing address
2936 HIGHLAND DR STE 101, SLC, UT 84106-3583
(801) 467-6555
(801) 474-0103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
275081-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018294
—
NM
05
—
1017004720001
—
PA
05
—
115674
—
MT
05
—
143256
—
SD
01
—
793952
UNITED CONCORDIA
—
05
—
817463
—
AZ
05
—
87384051
—
NM
05
—
DD275UT
—
AK
05
—
G91893-01
—
CA
Enumeration date
03/08/2007
Last updated
07/09/2007
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