Healthcare Provider Details

I. General information

NPI: 1710955471
Provider Name (Legal Business Name): ORAL AND MAXILLOFACIAL SURGERY AFFILATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 MALLORY LN SUITE 100
FRANKLIN TN
37067-2830
US

IV. Provider business mailing address

1909 MALLORY LN SUITE 100
FRANKLIN TN
37067-2830
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-1983
  • Fax: 615-771-2432
Mailing address:
  • Phone: 615-771-1983
  • Fax: 615-771-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY P URBANEK
Title or Position: DOCTOR
Credential: D.D.S. , M.D.
Phone: 615-771-1983