| Regional Oral Surgery Center Pc | |
|
33 W 3rd St Cookeville TN 38501-2513 | |
| (931) 528-6252 | |
| (931) 372-8526 |
| Full Name | Regional Oral Surgery Center Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 33 W 3rd St, Cookeville, Tennessee |
| Authorized Official Name and Position | Robert Edwin Brooksbank (PRESIDENT) |
| Authorized Official Contact | 9315286252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regional Oral Surgery Center Pc 33 W 3rd St Cookeville TN 38501-2513 Ph: (931) 528-6252 | Regional Oral Surgery Center Pc 33 W 3rd St Cookeville TN 38501-2513 Ph: (931) 528-6252 |
| NPI Number | 1235213869 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 07/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235213869 | NPI | - | NPPES |
| 3226337 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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