Organization
REGIONAL ORAL SURGERY CENTER PC
Active
Organization
REGIONAL ORAL SURGERY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT EDWIN BROOKSBANK D.D.S. (PRESIDENT)
(931) 528-6252
Entity
Organization
Contact information
Practice address
33 W 3RD ST, COOKEVILLE, TN 38501-2513
(931) 528-6252
(931) 372-8526
Mailing address
33 W 3RD ST, COOKEVILLE, TN 38501-2513
(931) 528-6252
(931) 372-8526
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3226337
—
TN
Enumeration date
10/24/2006
Last updated
07/10/2013
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