Provider Demographics
NPI:1023006673
Name:CASE, TIMOTHY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:S
Last Name:CASE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 TENNESSEE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-1352
Mailing Address - Country:US
Mailing Address - Phone:423-821-9771
Mailing Address - Fax:423-821-9772
Practice Address - Street 1:3918 TENNESSEE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37409-1352
Practice Address - Country:US
Practice Address - Phone:423-821-9771
Practice Address - Fax:423-821-9772
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN012706122300000X
TNDS7950122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA451060946AMedicaid
GA451060946CMedicaid
GA451060946BMedicaid