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Individual

TIMOTHY F CHAPMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2101 RIVERSIDE DR, BELOIT, WI 53511-2932
(608) 365-4006
(608) 365-4870
Mailing address
2101 RIVERSIDE DR, BELOIT, WI 53511-2932
(608) 365-4006
(608) 365-4870

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
5002032
WI
1223G0001X
General Practice Dentistry
Primary
5002032
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33368700
WI
Enumeration date
04/10/2008
Last updated
04/10/2008
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