Organization
KNOB CREEK ORAL CLINIC
Active
Organization
KNOB CREEK ORAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDFORD W PRINCE DMD (ORAL SURGEON)
(423) 467-5010
Entity
Organization
Contact information
Practice address
2306 KNOB CREEK RD, SUITE 108, JOHNSON CITY, TN 37604-2366
(423) 467-5009
Mailing address
2306 KNOB CREEK RD, SUITE 108, JOHNSON CITY, TN 37604-2366
(423) 467-5009
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DS0000009647
TN
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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