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Individual

MARTIN A FERNUNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
11511 NE 195TH ST STE 104, BOTHELL, WA 98011-5769
(425) 481-5302
Mailing address
11511 NE 195TH ST STE 104, BOTHELL, WA 98011-5769
(425) 481-5302

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEN00010521
WA
1223P0700X
Prosthodontics
Primary
DE00010521
WA

Other

Enumeration date
11/16/2006
Last updated
06/04/2025
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