Individual
DR. GABRIEL WILEY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
130 THOMPSON ST, ASHLAND, VA 23005-1526
(804) 798-2776
(804) 798-3110
Mailing address
1621 CHARLES ST, RICHMOND, VA 23226-3502
(804) 337-4146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411475
VA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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