Organization
JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW SHERBAN DMD (PRESIDENT)
(423) 283-4555
Entity
Organization
Contact information
Practice address
1021 W OAKLAND AVE STE 109, JOHNSON CITY, TN 37604-2192
(423) 283-4555
Mailing address
1021 W OAKLAND AVE STE 109, JOHNSON CITY, TN 37604-2192
(423) 283-4555
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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