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Organization

ORAL SURGICAL INSTITUTE, P.C.

Active
Parent organization
ORAL SURGICAL INSTITUTE, P.C.
Other names
Oral Surgery Institute - Springfield
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORAL SURGICAL INSTITUTE, P.C.
Authorized official
KIM WILSON (CRED SUPERVISOR)
(217) 540-5170
Entity
Organization

Contact information

Practice address
314 NORTHCREST DR STE 134, SPRINGFIELD, TN 37172-3963
(615) 384-1104
Mailing address
314 NORTHCREST DRIVE, SUITE 134, SPRINGFIELD, TN 37172
(615) 384-1104

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/07/2014
Last updated
10/07/2014
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