Individual
DR. GARY ERICKSON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1723 E LINCOLN AVE, SUNNYSIDE, WA 98944-2478
(509) 837-4022
(509) 839-4022
Mailing address
1723 E LINCOLN AVE, SUNNYSIDE, WA 98944-2478
(509) 837-4022
(509) 839-4022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
354974-9921
UT
1223G0001X
General Practice Dentistry
Primary
DE00005731
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5045802
—
WA
Enumeration date
04/14/2006
Last updated
04/25/2012
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