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

East Tennessee Oral and Maxillofacial Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1861701005

East Tennessee Oral and Maxillofacial Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Knoxville, 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.

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Practice location Address checks out

161 Capital Drive SUITE102
Knoxville, TN 37922-3357
Phone: (865) 531-3909
Fax: (865) 539-0022
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 number1861701005
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Widloski — Owner · (865) 983-8630
NPI enumeratedOctober 6, 2010
Last updated in NPPESNovember 29, 2010
Mailing address1505 E Lamar Alexander Pkwy, Maryville, TN 37804-5131

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