# DR. ROBERT JOHN TIMOTHY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811953276
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-3060 | ID | — |
| 1223X0008X | Oral and Maxillofacial Radiology Dentistry | 145092-9921 | UT | Yes |

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 12/20/2021