Provider Demographics
NPI:1114218179
Name:TIMOTHY S. FOSTER, DMD
Entity Type:Organization
Organization Name:TIMOTHY S. FOSTER, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-883-7700
Mailing Address - Street 1:2531 PARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2158
Mailing Address - Country:US
Mailing Address - Phone:615-883-7700
Mailing Address - Fax:
Practice Address - Street 1:2531 PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2158
Practice Address - Country:US
Practice Address - Phone:615-883-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty