Individual
TIMOTHY DENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12479
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588733984
—
MO
01
—
431653349
TAX ID #
MO
Enumeration date
11/07/2006
Last updated
10/23/2018
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