Timothy, Robert John

Timothy, Robert John is an individual health care provider with primary practice located at 215 S 4Th St , Montpelier ID 83254-1591. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Radiology. Dental Providers / Oral and Maxillofacial Radiology is his primary health care specialty. Timothy, Robert John can be contacted via phone (208) 847-0153.

Contact Information

Primary practice address
215 S 4Th St Montpelier ID 83254-1591
Phone: (208) 847-0153
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D-3060 Idaho
Dental Providers / Oral and Maxillofacial Radiology 1223X0008X 145092-9921 Utah

Profile Details

NPI number 1811953276
LBN Legal business name Timothy, Robert John
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Dec 20th, 2021 - 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 1811953276 NPPES
Idaho MEDICAID 003303600

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