Organization
SOUTHEAST ORAL SURGERY PC
Active
Organization
SOUTHEAST ORAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE L TRACY (OFFICE MANAGER)
(865) 977-7110
Entity
Organization
Contact information
Practice address
11548 CHAPMAN HWY, SEYMOUR, TN 37865
(865) 577-7800
Mailing address
11548 CHAPMAN HWY, SEYMOUR, TN 37865
(865) 577-7800
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
04/15/2009
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