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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