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General NPI Number Information
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NPI Number | 1831196740
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Entity Type | Individual
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Provider Name | TIMOTHY LYNN VOLA D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 1562 WELLS RD SUITE 16
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City | ORANGE PARK
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State | FL
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Zip | 32073-1726
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Country | US
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Telephone | 904-644-0140
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Fax | 904-644-0143
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Provider Business Mailing Address
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Address Line | 2280 COBB DR
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City | TALLAHASSEE
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State | FL
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Zip | 32312-3170
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Country | US
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Telephone | 850-668-3736
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 010830
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN0010185
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License Number State | FL
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