Plateau Oral Surgery, Pc

LBN: Plateau Oral Surgery, Pc
Plateau Oral Surgery, Pc is an health care organization with primary practice located at 920 S Willow Ave , Cookeville TN 38501-4150. The organization recently has only one registered license in Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Plateau Oral Surgery, Pc can be contacted via phone (931) 525-6059, or through Kelly, Nancy J via phone (931) 525-6059.

Contact Information

Primary practice address
920 S Willow Ave Cookeville TN 38501-4150
Phone: (931) 525-6059
Fax: (931) 525-6079
Website:
Map and Directions
Authorized official contact:
Name: Kelly, Nancy J
Phone: (931) 525-6059

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery 261QS0112X D57545 Tennessee

Profile Details

NPI number 1730407560
LBN Legal business name Plateau Oral Surgery, Pc
DBA Doing business as
Authorized official Kelly, Nancy J
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2010
Last updated Jun 20th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730407560 NPPES
Tennessee MEDICAID 3226373

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