Provider Demographics
NPI:1811309321
Name:MARTINEZ LUNA, ACELA ALEJANDRA (DMD, MS)
Entity type:Individual
Prefix:
First Name:ACELA
Middle Name:ALEJANDRA
Last Name:MARTINEZ LUNA
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EAST CAROLINA UNIVERSITY - SCHOOL OF DENTAL MEDICINE
Mailing Address - Street 2:LEDYARD E. ROSS HALL 1851 MACGREGOR DOWNS ROAD
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4354
Mailing Address - Country:US
Mailing Address - Phone:252-737-7000
Mailing Address - Fax:
Practice Address - Street 1:1851 MACGREGOR DOWNS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5925
Practice Address - Country:US
Practice Address - Phone:252-737-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001861223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics