Organization
THE REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC
Active
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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