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Organization
TIMOTHY THEOBALD DDS PLLC
Active
Organization
TIMOTHY THEOBALD DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY DAVID THEOBALD DMD (LEAD DENTIST)
(847) 336-8478
Entity
Organization
Contact information
Practice address
2127 GREEN BAY RD, NORTH CHICAGO, IL 60064-2801
(847) 336-8478
Mailing address
2127 GREEN BAY RD, NORTH CHICAGO, IL 60064-2801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
05/29/2026
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