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Organization
FOOTHILLS ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization
FOOTHILLS ORAL AND MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GROSS (DDS/OWNER)
(865) 986-4582
Entity
Organization
Contact information
Practice address
603 HIGHWAY 321 N, BLDG. 4, UNIT 20, LENOIR CITY, TN 37771-6575
(865) 986-4582
Mailing address
PO BOX 4879, MARYVILLE, TN 37802-4879
(865) 986-3865
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS7297
TN
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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