Gross, Paul Dwayne

Gross, Paul Dwayne is an individual health care provider with primary practice located at 603 Highway 321 N Unit 20 Bldg 4 Lenoir City Prof. Park, Lenoir City TN 37771-6575. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gross, Paul Dwayne can be contacted via phone (865) 986-4582.

Contact Information

Primary practice address
603 Highway 321 N Unit 20 Bldg 4 Lenoir City Prof. Park Lenoir City TN 37771-6575
Phone: (865) 986-4582
Fax: (865) 988-8398
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS2495 Tennessee

Profile Details

NPI number 1417954629
LBN Legal business name Gross, Paul Dwayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417954629 NPPES
Tennessee MEDICAID 3225912

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