Individual
AMANDA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 S TRACY BLVD STE 170, TRACY, CA 95376-9111
(209) 836-5441
Mailing address
3776 CHIAVARI WAY, MANTECA, CA 95337-8469
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
110658
CA
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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