Johnson, Timothy Terell
Johnson, Timothy Terell is an sole proprietor health care provider with primary practice located at 512 W Fulton St , Canton MS 39046-4254. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Johnson, Timothy Terell can be contacted via phone (601) 855-5885.Contact Information
Primary practice address
512 W Fulton St
Canton MS 39046-4254
Phone: (601) 855-5885
Fax: (601) 855-2833
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 3108-99 | Mississippi |
Profile Details
| NPI number | 1316042237 |
|---|---|
| LBN Legal business name | Johnson, Timothy Terell |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1316042237 | NPPES |
| Mississippi | MEDICAID | 0060251 |
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