Provider Demographics
NPI:1013018241
Name:TIMOTHY R. STOLL DDS LLC
Entity Type:Organization
Organization Name:TIMOTHY R. STOLL DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:STOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-783-9898
Mailing Address - Street 1:1625 HWY 88
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89705
Mailing Address - Country:US
Mailing Address - Phone:775-783-9898
Mailing Address - Fax:775-782-9484
Practice Address - Street 1:1625 HWY 88
Practice Address - Street 2:SUITE 201
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89705
Practice Address - Country:US
Practice Address - Phone:775-783-9898
Practice Address - Fax:775-782-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty