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General NPI Number Information
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NPI Number | 1760604177
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Entity Type | Individual
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Provider Name | TIMOTHY NED PICKENS DDS,MS
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3183 THISTLE CT
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City | SALINE
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State | MI
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Zip | 48176-9576
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Country | US
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Telephone | 734-904-7602
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Fax | 734-429-5774
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Provider Business Mailing Address
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Address Line | 3183 THISTLE CT
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City | SALINE
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State | MI
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Zip | 48176-9576
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Country | US
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Telephone | 734-904-7602
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Fax | 734-429-5774
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2901010019
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2211
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License Number State | AZ
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