| Ocoee Oral Surgery Pc | |
|
2222 Chambliss Ave Nw Cleveland TN 37311-3895 | |
| (423) 479-8544 | |
| (423) 479-1444 |
| Full Name | Ocoee Oral Surgery Pc |
|---|---|
| Speciality | Dentist |
| Location | 2222 Chambliss Ave Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Paul T Mccord (OWNER) |
| Authorized Official Contact | 4234798544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocoee Oral Surgery Pc 2222 Chambliss Ave Nw Cleveland TN 37311-3895 Ph: (423) 479-8544 | Ocoee Oral Surgery Pc 2222 Chambliss Ave Nw Cleveland TN 37311-3895 Ph: (423) 479-8544 |
| NPI Number | 1538338579 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 02/08/2013 |
| Medicare PECOS PAC ID | 8224116330 |
|---|---|
| Medicare Enrollment ID | O20080415000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538338579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS3297 (Tennessee) | Primary |
| Provider Name | Paul T Mccord |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1366435711 PECOS PAC ID: 9234217340 Enrollment ID: I20080415000309 |
| Provider Name | Hunter T Mccord |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457502916 PECOS PAC ID: 4688814106 Enrollment ID: I20130705000300 |
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