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General NPI Number Information
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NPI Number | 1396011664
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Entity Type | Organization
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Legal Business Name | TIMOTHY P. RESUTA, D.M.D., P.C.
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 3280 HOWELL MILL ROAD NW SUITE 339
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City | ATLANTA
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State | GA
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Zip | 30327-4109
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Country | US
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Telephone | 404-351-1035
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Fax | 404-609-9221
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Provider Business Mailing Address
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Address Line | 3280 HOWELL MILL ROAD NW SUITE 339
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City | ATLANTA
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State | GA
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Zip | 30327-4109
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Country | US
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Telephone | 404-351-1035
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Fax | 404-609-9221
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. TIMOTHY PHILLIP RESUTA
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Credential | D.M.D.
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Telephone | 404-351-1035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DNO12695
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License Number State | GA
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