Organization
MID-STATE ORAL SURGERY OF LEBANON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HIGHTOWER (DIRECTOR OF REVENUE)
(615) 441-1441
Entity
Organization
Contact information
Practice address
102 HARTMANN DR STE H, LEBANON, TN 37087-1502
(615) 441-1441
Mailing address
445 HENSLEE DR, DICKSON, TN 37055-2166
(615) 441-1441
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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