Organization
SOUTH SOUND ORAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA JEAN CASWELL (OFFICE MANAGER)
(360) 736-0715
Entity
Organization
Contact information
Practice address
1220 W 1ST ST, STE A, CENTRALIA, WA 98531-3018
(360) 736-0715
(360) 330-5091
Mailing address
1220 W 1ST W, STE A, CENTRALIA, WA 98531
(360) 736-0715
(360) 330-5091
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
07/25/2008
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