# DR BRENT MARTIN DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River Rock Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194539577
- **Authorized official:** BRENT MARTIN DMD (OWNER/DENTIST)
- **Authorized official phone:** (509) 314-6600

## Contact information

- **Practice address:** 812 ZILLAH WEST RD, ZILLAH, WA 98953-9542
- **Practice address phone:** (509) 314-6600
- **Practice address fax:** (844) 314-6603
- **Mailing address:** 812 ZILLAH WEST RD, ZILLAH, WA 98953-9542
- **Mailing address phone:** (509) 314-6600
- **Mailing address fax:** (844) 314-6603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 02/05/2025
- **Last updated:** 02/05/2025