Provider Demographics
NPI:1730345091
Name:ENG, MARTHA CRISTINA (DMD)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:CRISTINA
Last Name:ENG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5346
Mailing Address - Country:US
Mailing Address - Phone:786-391-4566
Mailing Address - Fax:786-391-4590
Practice Address - Street 1:427 HIALEAH DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5346
Practice Address - Country:US
Practice Address - Phone:786-391-4566
Practice Address - Fax:786-391-4590
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 17980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist