Individual
DR. TIMOTHY ALLEN MITCHENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.P.H.
Contact information
Practice address
5158 BLACK HAWK RD, GUNPOWDER, MD 21010-5403
(410) 436-5001
Mailing address
5158 BLACK HAWK RD, GUNPOWDER, MD 21010-5403
(410) 436-5001
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DS0000004875
TN
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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