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1928 Alcoa Hwy Ste 305 Knoxville TN 37920-1502 | |
| (865) 305-6625 | |
| (865) 305-6628 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1928 Alcoa Hwy, Knoxville, Tennessee |
| Authorized Official Name and Position | Beth A Maynard (VICE PRESIDENT) |
| Authorized Official Contact | 8653056427 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 415000-msc8154 Nashville TN 37241-8154 Ph: (865) 670-6199 | 1928 Alcoa Hwy Ste 305 Knoxville TN 37920-1502 Ph: (865) 305-6625 |
| NPI Number | 1699133009 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 08/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699133009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Secondary |
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