Individual
MARTIEZ OCTAVIUS SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
729 E RAILROAD AVE, FORT MORGAN, CO 80701-3340
(970) 484-0999
(970) 867-2511
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 697-2583
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204944
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/21/2021
Last updated
05/16/2022
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