Martinez, Richard Dale
Martinez, Richard Dale is an sole proprietor health care provider with primary practice located at 2936 Highland Dr Ste 101 , Slc UT 84106-3583. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Martinez, Richard Dale can be contacted via phone (801) 467-6555.Contact Information
Primary practice address
2936 Highland Dr Ste 101
Slc UT 84106-3583
Phone: (801) 467-6555
Fax: (801) 474-0103
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 275081-9922 | Utah |
Profile Details
| NPI number | 1689705782 |
|---|---|
| LBN Legal business name | Martinez, Richard Dale |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 8th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689705782 | NPPES |
| Montana | MEDICAID | 115674 | |
| Montana | Other | 793952 | |
| Montana | MEDICAID | 0018294 | |
| Montana | MEDICAID | 87384051 | |
| Montana | MEDICAID | DD275UT | |
| Montana | MEDICAID | G91893-01 | |
| Montana | MEDICAID | 143256 | |
| Montana | MEDICAID | 1017004720001 | |
| Montana | MEDICAID | 817463 |
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