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General NPI Number Information
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NPI Number | 1407066954
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Entity Type | Individual
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Provider Name | TIMOTHY ALLEN BIBLE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 123 LEINART ST
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City | CLINTON
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State | TN
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Zip | 37716-3626
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Country | US
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Telephone | 865-457-2860
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Fax | 865-457-5602
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Provider Business Mailing Address
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Address Line | 300 TIMBERCREST DR
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City | CLINTON
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State | TN
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Zip | 37716-2105
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Country | US
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Telephone | 865-463-7997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS0000007253
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License Number State | TN
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