| NPI | 1609900638 |
|---|---|
| Other Name | ORAL AND MAXILLOFACIAL SURGERY OF LAKEWOOD |
| Entity Type | Organization |
| Authorized Contact | DAVID A COTANT Owner President 253-584-0858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE00003794) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |