| Oral Surgery Northwest | |
|
7424 Bridgeport Way W Suite 311 Lakewood WA 98499-8120 | |
| (253) 588-1701 | |
| (253) 588-8832 |
| Full Name | Oral Surgery Northwest |
|---|---|
| Speciality | Dentist |
| Location | 7424 Bridgeport Way W, Lakewood, Washington |
| Authorized Official Name and Position | Rosa Maria Cortesi (OFFICE MANAGER) |
| Authorized Official Contact | 2535881701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Northwest 7424 Bridgeport Way W Suite 311 Lakewood WA 98499-8120 Ph: (253) 588-1701 | Oral Surgery Northwest 7424 Bridgeport Way W Suite 311 Lakewood WA 98499-8120 Ph: (253) 588-1701 |
| NPI Number | 1134343775 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134343775 | NPI | - | NPPES |
| 5048327 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00008264 (Washington) | Primary |
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