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General NPI Number Information
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NPI Number | 1639215106
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Entity Type | Individual
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Provider Name | TIMOTHY CLAYTON MERCER DMD
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3590 WEBBER ST
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City | SARASOTA
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State | FL
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Zip | 34239-4929
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Country | US
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Telephone | 941-922-1818
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Fax | 941-924-2067
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Provider Business Mailing Address
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Address Line | PO BOX 154
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City | TERRA CEIA
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State | FL
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Zip | 34250-0154
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Country | US
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Telephone | 941-723-9909
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Fax | 941-924-2067
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN-14624
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License Number State | FL
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