Individual
TIMOTHY BURNETTE NAOMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
(028) 525-8385
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11061
KY
1223G0001X
General Practice Dentistry
6597
NC
1223G0001X
General Practice Dentistry
Primary
DE60857601
WA
1223G0001X
General Practice Dentistry
DEN5340
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89902MW
—
NC
Enumeration date
05/10/2006
Last updated
03/05/2026
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