Provider Demographics
NPI:1295806941
Name:FOLKMAN, GARY REID (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:REID
Last Name:FOLKMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 5TH AVE NW PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAN
Mailing Address - State:WA
Mailing Address - Zip Code:98027
Mailing Address - Country:US
Mailing Address - Phone:425-392-5602
Mailing Address - Fax:525-392-5531
Practice Address - Street 1:1000 5TH AVE NW
Practice Address - Street 2:
Practice Address - City:ISSAQUAN
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-392-5602
Practice Address - Fax:525-392-5531
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist