Individual
DR. TIMOTHY SCOT BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
CORNER OF RT N12 & N7, FORT DEFIANCE INDIAN HOSPITAL, FORT DEFIANCE, AZ 86504
(928) 729-8892
(928) 729-8888
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8892
(928) 729-8888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3832-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766660
—
AZ
05
—
88534
—
NM
Enumeration date
10/31/2006
Last updated
07/19/2011
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