Organization
ORAL & MAXILLOFACIAL SURGERY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE 'TED' A GEORGE JR. DDS (ORAL SURGEON VICE PRESIDENT)
(865) 675-0677
Entity
Organization
Contact information
Practice address
11213 W POINT DR STE 501, KNOXVILLE, TN 37934-2838
(865) 675-0677
(865) 675-0681
Mailing address
11213 W POINT DR STE 501, KNOXVILLE, TN 37934-2838
(865) 675-0677
(865) 675-0681
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DS02991
TN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DS04769
TN
Other
Enumeration date
05/27/2008
Last updated
05/29/2019
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