Individual
DR. TIMOTHY WALTER PENBERTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
509 W HANLEY AVE, SUITE # 2, COEUR D ALENE, ID 83815-8994
(208) 664-8622
Mailing address
509 W HANLEY AVE, SUITE # 2, COEUR D ALENE, ID 83815-8994
(208) 664-8622
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D-1930-EN
ID
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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