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General NPI Number Information
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NPI Number | 1760447122
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Entity Type | Organization
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Legal Business Name | ORAL SURGERY ASSOCIATES INC.
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3924 MARTIN WAY E
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City | OLYMPIA
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State | WA
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Zip | 98506-5220
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Country | US
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Telephone | 360-456-8610
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Fax | 360-493-8179
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Provider Business Mailing Address
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Address Line | 3924 MARTIN WAY E
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City | OLYMPIA
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State | WA
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Zip | 98506-5220
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Country | US
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Telephone | 360-456-8610
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Fax | 360-493-8179
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD GEORGE DOLGASH
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Credential | DDS
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Telephone | 360-456-8610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 4068
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License Number State | WA
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