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Organization
MANUEL LA ROSA DDS PS
Active
Organization
MANUEL LA ROSA DDS PS
Active
Other names
Sound Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL J LA ROSA-CRAIG DDS (PRESIDENT)
(253) 564-1000
Entity
Organization
Contact information
Practice address
1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
(253) 564-1000
(253) 564-0102
Mailing address
1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
(253) 564-1000
(253) 564-0102
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE8413
WA
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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