East Tennessee Oral & Maxillofacial Surgery, PC
NPI #1033429030 in Greeneville, Tennessee
Provider Information
- NPI Number
- 1033429030
- Entity Type
- Organization
- Organization Name
- East Tennessee Oral & Maxillofacial Surgery, PC
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Oct 12, 2010
- Last Updated
- Nov 18, 2010
Practice Location
- Address
- 703 K ST
- City
- Greeneville
- State
- Tennessee
- ZIP Code
- 37745-6246
- Phone
- (423) 639-6769
Authorized Official
- Name
- DR. MARK M WIDLOSKI, DDS
- Title
- OWNER
- Phone
- (865) 983-8630
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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