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General NPI Number Information
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NPI Number | 1427906890
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Entity Type | Organization
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Legal Business Name | MOLEN MAXILLOFACIAL SURGERY, INC.
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 16202 64TH ST E
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City | SUMNER
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State | WA
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Zip | 98390-3028
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Country | US
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Telephone | 253-470-5020
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Fax | 253-333-9753
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Provider Business Mailing Address
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Address Line | 16202 64TH ST E STE 118
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City | SUMNER
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State | WA
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Zip | 98390-3028
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Country | US
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Telephone | 253-470-5020
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Fax | 253-333-9753
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID GLENN MOLEN
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Credential | DDS, MD
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Telephone | 253-592-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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