Organization
SOUTH SOUND ORAL SURGERY PLLC
Active
Parent organization
DUPONT ORAL SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
DUPONT ORAL SURGERY
Authorized official
DR. MICHAEL E WERNER D.M.D. (DOCTOR)
(253) 579-0000
Entity
Organization
Contact information
Practice address
1100 STATION DR STE 181, DUPONT, WA 98327-9777
(253) 579-0000
(253) 579-0010
Mailing address
1100 STATION DR STE 181, DUPONT, WA 98327-9777
(253) 579-0000
(253) 579-0010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7171
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8039
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9913
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1223S0112X
—
WA
Enumeration date
09/08/2011
Last updated
09/08/2011
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