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
3425 ENSIGN RD NE, SUITE 310, OLYMPIA, WA 98506
(360) 456-5678
(356) 045-6123
Mailing address
3425 ENSIGN RD NE, STE 310, OLYMPIA, WA 98506
(360) 456-5678
(360) 456-1238
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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