Individual
DR. TIMOTHY MARK DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
989375 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-9375
(402) 559-7962
(402) 559-9607
Mailing address
989375 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-9375
(402) 559-7962
(402) 559-9607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5428
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025144400
—
NE
05
—
1956599
—
IA
01
—
4851
BCBS
NE
Enumeration date
01/29/2007
Last updated
02/18/2008
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