# SOUTH SOUND ORAL SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DUPONT ORAL SURGERY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942581681
- **Legal business name:** DUPONT ORAL SURGERY
- **Authorized official:** DR. MICHAEL E WERNER D.M.D. (DOCTOR)
- **Authorized official phone:** (253) 579-0000

## Contact information

- **Practice address:** 1100 STATION DR STE 181, DUPONT, WA 98327-9777
- **Practice address phone:** (253) 579-0000
- **Practice address fax:** (253) 579-0010
- **Mailing address:** 1100 STATION DR STE 181, DUPONT, WA 98327-9777
- **Mailing address phone:** (253) 579-0000
- **Mailing address fax:** (253) 579-0010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7171 | WA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 8039 | WA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 9913 | WA | Yes |

## Other

- **Enumeration date:** 09/08/2011
- **Last updated:** 09/08/2011