MEDICARE: DR. GEORGE PETER SURANYI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DS0000008722	TN

General Provider Information

NPI Number	:	1811185010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE PETER SURANYI DMD

Provider Business Mailing Address
First Line	:	550 TOWN CREEK RD E STE 202
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37772-6289
Country	:	US
Telephone Number	:	865-988-3332
Fax Number	:	865-988-3343

Provider Business Practice Location Address
First Line	:	550 TOWN CREEK RD E STE 202
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37772-6289
Country	:	US
Telephone Number	:	865-988-3332
Fax Number	:	865-988-3343

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2007
Last Update Date	:	02/01/2010

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