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General NPI Number Information
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NPI Number | 1922917178
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Entity Type | Organization
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Legal Business Name | FEDERAL WAY ORAL SURGERY PC
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 33801 1ST WAY S STE 311
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4548
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Country | US
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Telephone | 817-646-0089
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Fax |
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Provider Business Mailing Address
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Address Line | 33801 1ST WAY S STE 311
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4548
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Country | US
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Telephone | 817-646-0089
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JILL DUNNAM
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Credential |
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Telephone | 817-226-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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