Provider Demographics
NPI:1700171410
Name:NORTH SOUND ORAL AND FACIAL SURGERY P.S.
Entity Type:Organization
Organization Name:NORTH SOUND ORAL AND FACIAL SURGERY P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARDEEP
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-293-2808
Mailing Address - Street 1:2620 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2732
Mailing Address - Country:US
Mailing Address - Phone:360-293-2808
Mailing Address - Fax:360-293-0306
Practice Address - Street 1:2620 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2732
Practice Address - Country:US
Practice Address - Phone:360-293-2808
Practice Address - Fax:360-293-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010052261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery