Organization
ORAL SURGERY NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA MARIA CORTESI (OFFICE MANAGER)
(253) 588-1701
Entity
Organization
Contact information
Practice address
7424 BRIDGEPORT WAY W, SUITE 311, LAKEWOOD, WA 98499-8120
(253) 588-1701
(253) 588-8832
Mailing address
7424 BRIDGEPORT WAY W, SUITE 311, LAKEWOOD, WA 98499-8120
(253) 588-1701
(253) 588-8832
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00008264
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048327
—
WA
Enumeration date
04/13/2007
Last updated
08/22/2020
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