Individual
DR. TIM ALLEN NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
585 CLAUD RD, ECLECTIC, AL 36024-6318
(334) 541-4002
(334) 541-4021
Mailing address
PO BOX 240817, ECLECTIC, AL 36024-0016
(334) 541-4002
(334) 541-4021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4536
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79554
BLUECROSS BLUESHIELD OF A
AL
01
—
801429
UNITED CONCORDIA
AL
Enumeration date
10/10/2006
Last updated
05/01/2008
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