South Sound Oral Surgery PLLC
Dentist, Oral and Maxillofacial Surgery in Centralia, WA. Organization (NPI-2).
NPI number1396830238
StatusActive
Last updated in NPPESJul 25, 2008
Details
- NPI
- 1396830238
- Entity type
- Organization (NPI-2)
- Legal business name
- South Sound Oral Surgery PLLC
- Organization subpart
- No
- Enumeration date
- Oct 4, 2006
- Last updated
- Jul 25, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | Yes |
Practice location
1220 W 1st StSte A
Centralia, WA 98531-3018
Phone 360-736-0715 · Fax 360-330-5091
Mailing address
1220 W 1st WSte A
Centralia, WA 98531
Phone 360-736-0715 · Fax 360-330-5091
Authorized official
Laura Jean Caswell
Office Manager
3607360715
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