Organization
MIDDLE TENNESSEE ORAL SURGERY CENTER
Active
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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