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Individual

DR. TIMOTHY IVAN MCCONNELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
100 BERKELEY SQUARE LN, GOOSE CREEK, SC 29445-2958
(843) 553-5235
(843) 797-8189
Mailing address
PO BOX 1120, GOOSE CREEK, SC 29445-1120
(843) 553-5235
(843) 797-8189

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1759
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
79343
UNITED CONCORDIA INSURANC
SC
05
Z17599
SC
Enumeration date
05/05/2006
Last updated
07/08/2007
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