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General NPI Number Information
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NPI Number | 1912173782
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Entity Type | Organization
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Legal Business Name | TIMOTHY C. DENNY, D.D.S., LLC
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 16512 MANCHESTER RD
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City | WILDWOOD
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State | MO
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Zip | 63040-1217
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Country | US
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Telephone | 636-458-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 16512 MANCHESTER RD
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City | WILDWOOD
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State | MO
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Zip | 63040-1217
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Country | US
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Telephone | 636-458-2700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY C. DENNY
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Credential | D.D.S.
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Telephone | 636-458-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 012479
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License Number State | MO
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