Individual
DR. TIMOTHY F. CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
11 CANARY LN, WINCHESTER, KY 40391-1645
(859) 744-7031
(859) 744-9175
Mailing address
11 CANARY LN, WINCHESTER, KY 40391-1645
(859) 744-7031
(859) 744-9175
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6359
KY
1223P0221X
Pediatric Dentistry
Primary
6359
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6359
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60063591
—
KY
Enumeration date
02/02/2007
Last updated
04/20/2015
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