Individual
DR. TIMOTHY E HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
410 E WASHINGTON ST, SLINGER, WI 53086-9650
(262) 644-6951
(262) 644-6825
Mailing address
PO BOX 379, SLINGER, WI 53086-0379
(262) 644-6951
(262) 644-6825
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3137
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3137
DELTA
WI
05
—
33451600
—
WI
Enumeration date
12/18/2006
Last updated
07/08/2007
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