Provider Demographics
NPI:1134283427
Name:MEILLER, TIMOTHY FRANCIS (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:FRANCIS
Last Name:MEILLER
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UMB DENTAL SCHOOL
Mailing Address - Street 2:650 WEST BALTIMORE STREET, 7-NORTH
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-706-7625
Mailing Address - Fax:
Practice Address - Street 1:UMB DENTAL SCHOOL
Practice Address - Street 2:650 WEST BALTIMORE STREET, 7-NORTH
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-706-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00259525OtherRAILROAD MEDICATE
MDKK64 K615Medicare ID - Type Unspecified
MDP00259525OtherRAILROAD MEDICATE