# MANUEL LA ROSA DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sound Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861604415
- **Authorized official:** DR. MANUEL J LA ROSA-CRAIG DDS (PRESIDENT)
- **Authorized official phone:** (253) 564-1000

## Contact information

- **Practice address:** 1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
- **Practice address phone:** (253) 564-1000
- **Practice address fax:** (253) 564-0102
- **Mailing address:** 1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
- **Mailing address phone:** (253) 564-1000
- **Mailing address fax:** (253) 564-0102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE8413 | WA | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/22/2020