MEDICARE: DR. TIMOTHY S TRULOVE DMD., M.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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	4204	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4204	OTHER	AL	BOARD OF DENTAL EXAMINERS

General Provider Information

NPI Number	:	1669531695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY S TRULOVE DMD., M.S.

Provider Business Mailing Address
First Line	:	4164 CARMICHAEL RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-3600
Country	:	US
Telephone Number	:	334-277-2980
Fax Number	:	334-277-2987

Provider Business Practice Location Address
First Line	:	4164 CARMICHAEL RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-3600
Country	:	US
Telephone Number	:	334-277-2980
Fax Number	:	334-277-2987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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