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Organization

LEWIS CLARK ORAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN WALLACE MORRISON D.M.D. (OWNER)
(509) 751-1110
Entity
Organization

Contact information

Practice address
1119 HIGHLAND AVE, NUMBER 6, CLARKSTON, WA 99403-2836
(509) 751-1110
Mailing address
1119 HIGHLAND AVE, NUMBER 6, CLARKSTON, WA 99403-2836
(509) 751-1110

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE 00011204
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164567913
NPI - PERSONAL
ID
Enumeration date
11/30/2009
Last updated
11/30/2009
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