Organization
TIMOTHY P BASHFORD DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY PATRICK BASHFORD DDS (OWNER)
(847) 256-9507
Entity
Organization
Contact information
Practice address
400 LAKE COOK RD, DEERFIELD, IL 60015-5607
(847) 256-9507
(847) 256-9750
Mailing address
PO BOX 8347, NORTHFIELD, IL 60093-8347
(847) 256-9507
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019017695
IL
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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