| NPI | 1699989749 |
|---|---|
| Other Name | OLYMPIA ORAL & MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROSS KELSON Member 360-923-5412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA 7100) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |