NPI | 1538327655 |
---|---|
Entity Type | Organization |
Authorized Contact | THEODORE "TED" A GEORGE Oral Surgeon Vice President 865-675-0677 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN DS04769) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TN DS02991) |
Enumeration Date | 2008-05-27 |
Last Update Date | 2019-05-29 |