MANUEL LA ROSA DDS PS NPI 1861604415

NPI Information

NPI: 1861604415
Provider Name: MANUEL LA ROSA DDS PS

Doing Business As: SOUND ORAL AND MAXILLOFACIAL SURGERY

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1628 S MILDRED ST
SUITE 210
TACOMA, WA
ZIP 98465
Phone: (253) 564-1000
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MANUEL LA ROSA DDS PS is a dental clinic center in Tacoma, WA. MANUEL LA ROSA DDS PS NPI is 1861604415. The provider is registered as an organization entity type.
The provider Is Doing Business As Sound Oral And Maxillofacial Surgery.

The provider's business location address is:

1628 S MILDRED ST
SUITE 210
TACOMA, WA
ZIP 98465-627
Phone: (253) 564-1000
Fax: (253) 564-0102

The provider's authorized official is Manuel J La Rosa-craig .
The authorized official title is President and has the following contact phone number (253) 564-1000.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	DE8413	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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