Prince, Sandford W

Prince, Sandford W is an sole proprietor health care provider with primary practice located at 2306 Knob Creek Road #108 Knob Creek Oral Clinic, Johnson City TN 37604. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Prince, Sandford W can be contacted via phone (423) 467-5009.

Contact Information

Primary practice address
2306 Knob Creek Road #108 Knob Creek Oral Clinic Johnson City TN 37604
Phone: (423) 467-5009
Fax: (423) 467-5009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Oral and Maxillofacial Surgery 261QS0112X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS0000009647 Tennessee

Profile Details

NPI number 1790750586
LBN Legal business name Prince, Sandford W
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2006
Last updated Mar 7th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790750586 NPPES
Tennessee Other 12683544 CAQH
Tennessee Other 465705259 CAQH

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