EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY, PC

SEVIERVILLE, TN
NPI1043520042
Entity TypeOrganization
Authorized ContactMARK M WIDLOSKI
Owner
865-983-8630
Organization Subpart ?No
Primary Taxonomy1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: TN  4711)
Enumeration Date2010-10-12
Last Update Date2010-11-18
Business Address
EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY, PC
1112 MEDICAL PARK CT
SEVIERVILLE, TN 37862-6933
Phone number: 865-453-1070
Mailing Address
EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY, PC
1505 E LAMAR ALEXANDER PKWY
MARYVILLE, TN 37804-5131
Phone number: 865-983-8630