Wolfenden, Timothy Rand

Wolfenden, Timothy Rand is an sole proprietor health care provider with primary practice located at 65 James St Suite 204, Worcester MA 01603-1026. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wolfenden, Timothy Rand can be contacted via phone (508) 753-8778.

Contact Information

Primary practice address
65 James St Suite 204 Worcester MA 01603-1026
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X MA16775 Massachusetts

Profile Details

NPI number 1760529978
LBN Legal business name Wolfenden, Timothy Rand
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760529978 NPPES
Massachusetts MEDICAID 0269697

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