| Tri-state Oral Surgery, Llc | |
|
405 Bentee Wes Ct Evansville IN 47715-4061 | |
| (812) 401-3500 | |
| (812) 401-3600 |
| Full Name | Tri-state Oral Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 405 Bentee Wes Ct, Evansville, Indiana |
| Authorized Official Name and Position | Mark E. Wohlford (OWNER) |
| Authorized Official Contact | 8124013500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Oral Surgery, Llc 405 Bentee Wes Ct Evansville IN 47715-4061 Ph: (812) 401-3500 | Tri-state Oral Surgery, Llc 405 Bentee Wes Ct Evansville IN 47715-4061 Ph: (812) 401-3500 |
| NPI Number | 1710366323 |
|---|---|
| Provider Enumeration Date | 05/28/2015 |
| Last Update Date | 05/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710366323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 12009501A (Indiana) | Primary |
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