Individual
TIMOTHY J MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
300 ARBORS DRIVE, SUITE 5, DRY RIDGE, KY 41035
(859) 823-0111
(859) 823-9111
Mailing address
300 ARBORS DRIVE, SUITE 5, DRY RIDGE, KY 41035
(859) 823-0111
(859) 823-9111
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
4988
KY
1223G0001X
General Practice Dentistry
Primary
4988
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60049889
—
KY
Enumeration date
09/27/2006
Last updated
04/05/2016
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