# SOUTH SOUND DENTURES,PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Sound Dental & Dentures
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669768545
- **Authorized official:** FRED E ELLIS DPD (OWNER/PRESIDENT)
- **Authorized official phone:** (360) 709-9909

## Contact information

- **Practice address:** 2728 WESTMOOR CT SW STE A, OLYMPIA, WA 98502-5779
- **Practice address phone:** (360) 709-9909
- **Practice address fax:** (360) 491-3883
- **Mailing address:** 2728 WESTMOOR CT SW STE A, OLYMPIA, WA 98502-5779
- **Mailing address phone:** (360) 709-9909
- **Mailing address fax:** (360) 491-3883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE10844 | WA | Yes |

## Other

- **Enumeration date:** 06/20/2011
- **Last updated:** 06/20/2011