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Organization
ORAL SURGICAL INSTITUTE, P.C.
Active
Organization
ORAL SURGICAL INSTITUTE, P.C.
Active
Parent organization
ORAL SURGICAL INSTITUTE, P.C.
Other names
Oral Surgery Institute - Springfield
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORAL SURGICAL INSTITUTE, P.C.
Authorized official
KIM WILSON (CRED SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
314 NORTHCREST DR STE 134, SPRINGFIELD, TN 37172-3963
(615) 384-1104
Mailing address
314 NORTHCREST DRIVE, SUITE 134, SPRINGFIELD, TN 37172
(615) 384-1104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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