Individual
TIMOTHY DAUDELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2707
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204821
CO
1223G0001X
General Practice Dentistry
DEN.00204821
CO
1223P0700X
Prosthodontics
Primary
DEN.00204821
CO
Other
Enumeration date
07/07/2021
Last updated
08/13/2026
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