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Organization

DONALD S. REDFORD, D.D.S, P.C

Active
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Organization

DONALD S. REDFORD, D.D.S, P.C

Active
Other names
Bristol Oral/Maxillofacial Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD SMITH REDFORD D.D.S (SURGEON/OWNER)
(423) 968-4114
Entity
Organization

Contact information

Practice address
350 BLOUNTVILLE HWY, SUITE 204, BRISTOL, TN 37620-0213
(423) 968-4114
(424) 968-4294
Mailing address
350 BLOUNTVILLE HWY, SUITE 204, BRISTOL, TN 37620-0213
(423) 968-4114
(424) 968-4294

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS003845
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0020203
TN
05
008019894
VA
Enumeration date
03/31/2008
Last updated
08/10/2013
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