# MARTIN & RODRIGUEZ DENTAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Martin Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154385771
- **Authorized official:** DR. J DOUGLAS RODRIGUEZ DDS (PARTNER)
- **Authorized official phone:** (509) 837-4022

## Contact information

- **Practice address:** 1723 E LINCOLN AVE, SUNNYSIDE, WA 98944-2478
- **Practice address phone:** (509) 837-4022
- **Practice address fax:** (509) 839-4022
- **Mailing address:** 1723 E LINCOLN AVE, SUNNYSIDE, WA 98944-2478
- **Mailing address phone:** (509) 837-4022
- **Mailing address fax:** (509) 839-4022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00005731 | WA | — |
| 1223G0001X | General Practice Dentistry | DE00007707 | WA | Yes |

## Other

- **Enumeration date:** 04/12/2006
- **Last updated:** 04/25/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5032123 | — | WA |