Provider Demographics
NPI:1033131362
Name:KING, TIMOTHY MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MARK
Last Name:KING
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:17700 N US HIGHWAY 281
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1404
Mailing Address - Country:US
Mailing Address - Phone:210-495-6255
Mailing Address - Fax:210-495-6260
Practice Address - Street 1:17700 N US HIGHWAY 281
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1404
Practice Address - Country:US
Practice Address - Phone:210-495-6255
Practice Address - Fax:210-495-6260
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX239391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics