SOUTHEAST ORAL SURGERY PC NPI 1154596286

NPI Information

  • NPI: 1154596286
  • Provider Name: SOUTHEAST ORAL SURGERY PC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 11548 CHAPMAN HWY
    SEYMOUR, TN
    ZIP 37865
  • Phone: (865) 577-7800

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NPI Details

SOUTHEAST ORAL SURGERY PC is an oral and maxillofacial surgery dentist in Seymour, TN. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SOUTHEAST ORAL SURGERY PC NPI is 1154596286. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11548 CHAPMAN HWY
SEYMOUR, TN
ZIP 37865
Phone: (865) 577-7800

The provider's authorized official is Michelle L Tracy .
The authorized official title is Office Manager and has the following contact phone number (865) 977-7110.

The enumeration date for this NPI number is 4/29/2008 and was last updated on 4/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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