Individual
GARY M TETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PS
Contact information
Practice address
3628 MERIDIAN ST, STE 1-C, BELLINGHAM, WA 98225
(360) 734-4374
(360) 715-9196
Mailing address
3628 MERIDIAN ST, STE 1-C, BELLINGHAM, WA 98225
(360) 734-4374
(360) 715-9196
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE0000455Z
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5514005
—
WA
Enumeration date
08/11/2006
Last updated
07/08/2007
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