Individual
IMELDA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1621 S ALAMEDA ST, COMPTON, CA 90220-4973
(310) 820-9933
Mailing address
1621 S ALAMEDA ST, COMPTON, CA 90220-4973
(310) 820-9933
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
75624
CA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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