| 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 |