Organization
SOUTH SOUND DENTURES,PS
Active
Other names
South Sound Dental & Dentures
Organization subpart
No
Provider details
NPI number
Authorized official
FRED E ELLIS DPD (OWNER/PRESIDENT)
(360) 709-9909
Entity
Organization
Contact information
Practice address
2728 WESTMOOR CT SW STE A, OLYMPIA, WA 98502-5779
(360) 709-9909
(360) 491-3883
Mailing address
2728 WESTMOOR CT SW STE A, OLYMPIA, WA 98502-5779
(360) 709-9909
(360) 491-3883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE10844
WA
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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