| Southeast Oral Surgery Pc | |
|
1858 Crest Rd Maryville TN 37804-4305 | |
| (865) 977-7110 | |
| (865) 977-4132 |
| Full Name | Southeast Oral Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1858 Crest Rd, Maryville, Tennessee |
| Authorized Official Name and Position | Timothy P Mcconnell (CEO) |
| Authorized Official Contact | 8659777110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Oral Surgery Pc 1858 Crest Rd Maryville TN 37804-4305 Ph: (865) 977-7110 | Southeast Oral Surgery Pc 1858 Crest Rd Maryville TN 37804-4305 Ph: (865) 977-7110 |
| NPI Number | 1184733446 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 04/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184733446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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