Provider Demographics
NPI:1710955471
Name:ORAL AND MAXILLOFACIAL SURGERY AFFILATES
Entity Type:Organization
Organization Name:ORAL AND MAXILLOFACIAL SURGERY AFFILATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:URBANEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS , MD
Authorized Official - Phone:615-771-1983
Mailing Address - Street 1:1909 MALLORY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2830
Mailing Address - Country:US
Mailing Address - Phone:615-771-1983
Mailing Address - Fax:615-771-2432
Practice Address - Street 1:1909 MALLORY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2830
Practice Address - Country:US
Practice Address - Phone:615-771-1983
Practice Address - Fax:615-771-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty