Organization
ORAL & FACIAL SURGERY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ROBERT WERTHER (PRESIDENT)
(615) 284-5650
Entity
Organization
Contact information
Practice address
300 20TH AVE N STE 606, NASHVILLE, TN 37203-5606
(615) 284-5650
(615) 284-5653
Mailing address
300 20TH AVE N STE 606, NASHVILLE, TN 37203-5606
(615) 284-5650
(615) 284-5653
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518204
—
TN
01
—
1912089871
INDIVIDUAL NPI ASSOCIATION
—
01
—
4043354
BCBS OF TN GROUP PROVIDER NUMBER
—
Enumeration date
10/19/2006
Last updated
04/10/2025
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