Organization
SOUTH SOUND AMBULATORY SURGERY CENTER, PLLC
Active
Parent organization
SOUTH SOUND ORAL SURGERY PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH SOUND ORAL SURGERY PLLC
Authorized official
JOSEPH C MULREAN DMD (CO-OWNER)
(360) 456-5678
Entity
Organization
Contact information
Practice address
3425 ENSIGN RD NE STE 310, OLYMPIA, WA 98506-5063
(360) 456-5678
(360) 456-1238
Mailing address
3425 ENSIGN RD NE STE 310, OLYMPIA, WA 98506-5063
(360) 456-5678
(360) 456-1238
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
601803289
WA
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
06/07/2017
Last updated
07/21/2022
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