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General NPI Number Information
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NPI Number | 1790013449
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Entity Type | Individual
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Provider Name | PHILLIP TIMMONS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | HOSPITAL AMERICANO, BASE NAVAL DE ROTA APARTADO DE CORREOS 33
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City | ROTA
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State | CADIZ
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Zip | 11530
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Country | ES
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Telephone | 349-568-2352
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 819 BOX 18
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City | FPO
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State | AE
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Zip | 09645-0001
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 24786
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License Number State | TX
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