Provider Demographics
NPI:1740683143
Name:ORAL SURGICAL INSTITUTE, P.C.
Entity type:Organization
Organization Name:ORAL SURGICAL INSTITUTE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRED SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-329-4401
Mailing Address - Street 1:125 COOL SPRINGS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6475
Mailing Address - Country:US
Mailing Address - Phone:615-778-0902
Mailing Address - Fax:
Practice Address - Street 1:125 COOL SPRINGS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6475
Practice Address - Country:US
Practice Address - Phone:615-778-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORAL SURGICAL INSTITUTE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-30
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty