NPI | 1669768545 |
---|---|
Doing Business As | SOUTH SOUND DENTAL & DENTURES |
Entity Type | Organization |
Authorized Contact | FRED E ELLIS Owner/President 360-709-9909 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE10844) |
Enumeration Date | 2011-06-20 |
Last Update Date | 2011-06-20 |