Individual
DR. TIMOTHEE GANSORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1138 MAIN ST UNIT C, JACKSBORO, TN 37757-2582
(423) 201-9917
(423) 377-1069
Mailing address
1138 MAIN ST UNIT C, JACKSBORO, TN 37757-2582
(423) 201-9917
(423) 377-1069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10591
TN
Other
Enumeration date
07/06/2017
Last updated
10/13/2021
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