Organization
MIDDLE TENNESSEE ORAL SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NOMA GWEBU B.S (OFFICE MANAGER)
(615) 327-2626
Entity
Organization
Contact information
Practice address
1801 CHURCH ST, NASHVILLE, TN 37203-2201
(615) 327-2626
(615) 327-2607
Mailing address
PO BOX 2162, BRENTWOOD, TN 37024-2162
(615) 327-2626
(615) 327-2607
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8035
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015802
ASSURANT
TN
01
—
1605591
UNITED CONCORDIA
TN
01
—
281433
CIGNA
TN
05
—
3731118
—
TN
01
—
4154703
BLUE CROSS BLUE SHIELD
TN
01
—
9176594
DORAL
TN
Enumeration date
04/23/2008
Last updated
04/23/2008
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