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General NPI Number Information
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NPI Number | 1528110814
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Entity Type | Organization
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Legal Business Name | DANIEL G. TIMMS DDS & JEFFREY KOSLOW DMD PA
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 1104 COOPER STREET
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City | DEPTFORD
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State | NJ
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Zip | 08096-3012
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Country | US
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Telephone | 856-845-1200
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Fax | 856-384-8308
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Provider Business Mailing Address
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Address Line | 1104 COOPER STREET
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City | DEPTFORD
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State | NJ
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Zip | 08096-3012
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Country | US
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Telephone | 856-845-1200
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Fax | 856-384-8308
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY KOSLOW
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Credential | D.M.D.
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Telephone | 856-845-1200
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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 | 10013
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21261
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12612
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License Number State | NJ
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