MEDICARE: TIMOTHY HO DMD, INC

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	1223G0001X	General Practice Dentistry	5764	NV

General Provider Information

NPI Number	:	1952603870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY HO DMD, INC

Provider Business Mailing Address
First Line	:	11350 SOUTHERN HIGHLANDS PKWY STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3291
Country	:	US
Telephone Number	:	702-242-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	11350 SOUTHERN HIGHLANDS PKWY STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3291
Country	:	US
Telephone Number	:	702-242-0088
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY NICHOLAS HO
Credential	:	DMD
Telephone Number	:	954-646-9600

Provider Enumeration Date	:	11/29/2010
Last Update Date	:	11/29/2010

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