Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Tennessee Oral & Maxillofacial Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1174624498

East Tennessee Oral & Maxillofacial Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Maryville, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1505 E Lamar Alexander Pkwy
Maryville, TN 37804-5131
Phone: (865) 983-8630
Fax: (865) 981-4914
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DS1794 (TN)

Record details

NPI number1174624498
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Widloski — Owner/Surgeon · (865) 983-8630
NPI enumeratedSeptember 26, 2006
Last updated in NPPESNovember 18, 2010
Mailing address1505 E Lamar Alexander Pkwy, Maryville, TN 37804-5131

Other providers in Maryville