Organization
MID-STATE ORAL SURGERY & IMPLANT CENTER, PC
Active
Organization
MID-STATE ORAL SURGERY & IMPLANT CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S. WILLIS DMD (OWNER)
(615) 441-1441
Entity
Organization
Contact information
Practice address
445 HENSLEE DR, DICKSON, TN 37055-2166
(615) 441-1441
(615) 441-1460
Mailing address
445 HENSLEE DR, DICKSON, TN 37055-2166
(615) 441-1441
(615) 441-1460
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9672
TN
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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