Gross, Paul Dwayne
Gross, Paul Dwayne is an individual health care provider with primary practice located at 603 Highway 321 N Unit 20 Bldg 4 Lenoir City Prof. Park, Lenoir City TN 37771-6575. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gross, Paul Dwayne can be contacted via phone (865) 986-4582.Contact Information
Primary practice address
603 Highway 321 N Unit 20 Bldg 4 Lenoir City Prof. Park
Lenoir City TN 37771-6575
Phone: (865) 986-4582
Fax: (865) 988-8398
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DS2495 | Tennessee |
Profile Details
| NPI number | 1417954629 |
|---|---|
| LBN Legal business name | Gross, Paul Dwayne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417954629 | NPPES |
| Tennessee | MEDICAID | 3225912 |
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