Provence, Timothy D
Provence, Timothy D is an individual health care provider with primary practice located at 207 23Rd Ave N , Nashville TN 37203-1501. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Provence, Timothy D can be contacted via phone (615) 320-1392.Contact Information
Primary practice address
207 23Rd Ave N
Nashville TN 37203-1501
Phone: (615) 320-1392
Fax: (615) 329-4245
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | Tennessee |
Profile Details
NPI number | 1982601829 |
---|---|
LBN Legal business name | Provence, Timothy D |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 7th, 2005 |
Last updated | Jul 8th, 2007 - about 18 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 | 1982601829 | NPPES |
Tennessee | MEDICAID | 3225637 |
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