Individual
DR. TIMOTHY THOMAS COYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD DDS
Contact information
Practice address
3015 S PROVIDENCE RD, SUITE 5, COLUMBIA, MO 65203
(573) 449-4900
(573) 875-6142
Mailing address
3015 S PROVIDENCE RD, SUITE 5, COLUMBIA, MO 65203
(573) 449-4900
(573) 875-6142
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
015920
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2002020403
MO
Other
Enumeration date
02/22/2006
Last updated
04/11/2017
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