Organization
MANUEL LA ROSA DDS PS
Active
Other names
Sound Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL J LA ROSA-CRAIG DDS (PRESIDENT)
(253) 564-1000
Entity
Organization
Contact information
Practice address
1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
(253) 564-1000
(253) 564-0102
Mailing address
1628 S MILDRED ST, SUITE 210, TACOMA, WA 98465-1627
(253) 564-1000
(253) 564-0102
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE8413
WA
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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