| Southeast Oral Surgery Pc | |
|
130 Mabry Hood Rd Suite 105 Knoxville TN 37922-2221 | |
| (865) 693-4442 | |
| (865) 977-4132 |
| Full Name | Southeast Oral Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 130 Mabry Hood Rd, Knoxville, Tennessee |
| Authorized Official Name and Position | Michelle L Tracy (OFFICE MANATER) |
| Authorized Official Contact | 8659777110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Oral Surgery Pc 130 Mabry Hood Rd Suite 105 Knoxville TN 37922-2221 Ph: (865) 693-4442 | Southeast Oral Surgery Pc 130 Mabry Hood Rd Suite 105 Knoxville TN 37922-2221 Ph: (865) 693-4442 |
| NPI Number | 1881992279 |
|---|---|
| Provider Enumeration Date | 03/09/2011 |
| Last Update Date | 03/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881992279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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