MEDICARE: DR. TIMOTHY MICHAEL BIZGA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30.022324	OH

General Provider Information

NPI Number	:	1750622676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY MICHAEL BIZGA D.D.S.

Provider Business Mailing Address
First Line	:	6731 RIDGE RD
Second Line	:	SUITE 201
City	:	PARMA
State	:	OH
Zip	:	44129-5708
Country	:	US
Telephone Number	:	440-884-6644
Fax Number	:	440-884-6691

Provider Business Practice Location Address
First Line	:	6731 RIDGE RD
Second Line	:	SUITE 201
City	:	PARMA
State	:	OH
Zip	:	44129-5708
Country	:	US
Telephone Number	:	440-884-6644
Fax Number	:	440-884-6691

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	03/04/2013

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