Herbst, Timothy M

Herbst, Timothy M is an individual health care provider with primary practice located at 402 W Jefferson St , Kirksville MO 63501-3407. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Dental Public Health. Dental Providers / Dental Public Health is his primary health care specialty. Herbst, Timothy M can be contacted via phone (660) 665-2741.

Contact Information

Primary practice address
402 W Jefferson St Kirksville MO 63501-3407
Phone: (660) 665-2741
Fax: (660) 665-3109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2001012903 Missouri
Dental Providers / Dental Public Health 1223D0001X 2001012903 Missouri

Profile Details

NPI number 1235115304
LBN Legal business name Herbst, Timothy M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Nov 6th, 2012 - about 13 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 1235115304 NPPES
Missouri MEDICAID 408444107

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