| Anderson Oral And Maxillofacial Surgery P.c. | |
|
2130 N Charles G Seivers Blvd Suite 1 Clinton TN 37716-6705 | |
| (865) 209-3651 | |
| Not Available |
| Full Name | Anderson Oral And Maxillofacial Surgery P.c. |
|---|---|
| Speciality | Dentist |
| Location | 2130 N Charles G Seivers Blvd, Clinton, Tennessee |
| Authorized Official Name and Position | James Greg Anderson (OWNER) |
| Authorized Official Contact | 8652093651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anderson Oral And Maxillofacial Surgery P.c. 2130 N Charles G Seivers Blvd Suite 1 Clinton TN 37716-6705 Ph: (865) 209-3651 | Anderson Oral And Maxillofacial Surgery P.c. 2130 N Charles G Seivers Blvd Suite 1 Clinton TN 37716-6705 Ph: (865) 209-3651 |
| NPI Number | 1316197619 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 09/23/2008 |
| Medicare PECOS PAC ID | 5092870949 |
|---|---|
| Medicare Enrollment ID | O20090210000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316197619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS0000005390 (Tennessee) | Primary |
| Provider Name | James G Anderson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1619952314 PECOS PAC ID: 1951496868 Enrollment ID: I20090117000081 |
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