| NPI | 1861604415 |
|---|---|
| Doing Business As | SOUND ORAL AND MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | MANUEL J LA ROSA-CRAIG President 253-564-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE8413) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |