Individual
DR. TIMOTHY F MC CONVILLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7017 OLD SAUK RD, MADISON, WI 53717-1010
(608) 833-1889
Mailing address
540 N NINE MOUND RD, VERONA, WI 53593-8677
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3066-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33467900
—
WI
Enumeration date
06/02/2006
Last updated
07/09/2007
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