Provider Demographics
NPI:1801202809
Name:B MARTIN AND G MARTIN PLLC
Entity Type:Organization
Organization Name:B MARTIN AND G MARTIN PLLC
Other - Org Name:SWEET DREAMS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-288-4884
Mailing Address - Street 1:1719 E. LINCOLN AVE.
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944
Mailing Address - Country:US
Mailing Address - Phone:509-288-4884
Mailing Address - Fax:509-288-4885
Practice Address - Street 1:1719 E. LINCOLN AVE.
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944
Practice Address - Country:US
Practice Address - Phone:509-288-4884
Practice Address - Fax:509-288-4885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00007707OtherINSURANCE
WADE00005731OtherINSURANCE
WADE60029611OtherINSURANCE
WADE00008085OtherINSURANCE