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General NPI Number Information
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NPI Number | 1790883742
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Entity Type | Individual
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Provider Name | TIMOTHY CHARLES BANDEEN DDS MS
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 4602 BECKLEY RD
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City | BATTLE CREEK
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State | MI
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Zip | 49015-7932
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Country | US
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Telephone | 269-963-4118
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Fax | 269-963-4167
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Provider Business Mailing Address
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Address Line | 4602 BECKLEY RD
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City | BATTLE CREEK
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State | MI
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Zip | 49015-7932
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Country | US
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Telephone | 269-963-4118
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Fax | 269-963-4167
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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 | 2901018532
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License Number State | MI
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