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 1770893778

East Tennessee Oral & Maxillofacial Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Athens, Tennessee. Licensed in Tennessee. Registered with an NPI since 2010.

Licensed in
TN
In the registry since
2010
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

307 Maple St
Athens, TN 37303-2957
Phone: (423) 745-8708
Fax: (423) 746-4562
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 4711 (TN)

Record details

NPI number1770893778
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Widloski — Owner · (865) 983-8630
NPI enumeratedOctober 12, 2010
Last updated in NPPESNovember 18, 2010
Mailing address1505 E Lamar Alexander Pkwy, Maryville, TN 37804-5131