Individual
WAYNE R. WITT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1505 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5131
(865) 983-8630
(865) 983-3616
Mailing address
1505 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5131
(865) 983-8630
(865) 983-3616
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS1794
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3215098
—
TN
Enumeration date
07/01/2005
Last updated
07/08/2007
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