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Organization

THE REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES EDWARD WITKOWSKI DDS (OWNER)
(423) 283-4555
Entity
Organization

Contact information

Practice address
1021 W OAKLAND AVE, SUITE 109, JOHNSON CITY, TN 37604-2191
(423) 283-4555
(423) 283-3044
Mailing address
1021 W OAKLAND AVE, SUITE 109, JOHNSON CITY, TN 37604-2191
(423) 283-4555
(423) 283-3044

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS004426
TN

Other

Enumeration date
08/20/2006
Last updated
08/22/2020
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