Individual
GERALDINE MANANSALA-MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3775 MARTIN WAY E STE A, OLYMPIA, WA 98506-5007
(360) 236-7166
Mailing address
5105 GRAND LOOP UNIT 804, TACOMA, WA 98407-3196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61422396
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2248269
—
WA
Enumeration date
03/23/2023
Last updated
06/22/2023
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