MEDICARE: TIMOTHY P RORMAN DDS

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	122300000X	Dentist	3345	NV
2	1223G0001X	General Practice Dentistry	3345	NV

General Provider Information

NPI Number	:	1952491201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY P RORMAN DDS

Provider Business Mailing Address
First Line	:	2960 SAINT ROSE PKWY STE 103
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4447
Country	:	US
Telephone Number	:	619-804-2814
Fax Number	:

Provider Business Practice Location Address
First Line	:	4035 S DURANGO DR
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-4161
Country	:	US
Telephone Number	:	702-804-8888
Fax Number	:	702-804-0559

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

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	06/12/2020

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Directions to “ TIMOTHY P RORMAN DDS” Practice Location

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