South Sound Dentures, P.s.

NPI #1487974341 in Olympia, Washington

Provider Information

NPI Number: 1487974341
Entity Type: Organization
Organization Name: South Sound Dentures, P.s.
Primary Specialty: Dentist
Enumeration Date: Jun 2, 2010
Last Updated: Jun 2, 2010

Practice Location

Address: 1822 BLACK LAKE BLVD. SW SUITE 101
City: Olympia
State: Washington
ZIP Code: 98512
Phone: (360) 709-9909

Authorized Official

Name: MRS. HEIDI ANNE ELLIS, D.H.
Title: OWNER
Phone: (360) 709-9909

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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