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NPI Code Detail

MEDICARE: DR. TIMOTHY WILLIAM SHEEHAN D.D.S.

MEDICARE:  DR. TIMOTHY WILLIAM SHEEHAN  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1467575209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY WILLIAM SHEEHAN D.D.S.
Provider Business Mailing Address
First Line : 525 TYLER RD
Second Line : SUITE K
City : SAINT CHARLES
State : IL
Zip : 60174-3305
Country : US
Telephone Number : 630-584-8444
Fax Number : 630-584-8488
Provider Business Practice Location Address
First Line : 525 TYLER RD
Second Line : SUITE K
City : SAINT CHARLES
State : IL
Zip : 60174-3305
Country : US
Telephone Number : 630-584-8444
Fax Number : 630-584-8488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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Directions to “ DR. TIMOTHY WILLIAM SHEEHAN D.D.S.” Practice Location

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