Provider Demographics
NPI:1235296989
Name:GARNER, TIMOTHY PAUL (DDS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PAUL
Last Name:GARNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:BURWELL
Mailing Address - State:NE
Mailing Address - Zip Code:68823-0369
Mailing Address - Country:US
Mailing Address - Phone:308-346-4988
Mailing Address - Fax:308-346-9103
Practice Address - Street 1:424 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BURWELL
Practice Address - State:NE
Practice Address - Zip Code:68823-4152
Practice Address - Country:US
Practice Address - Phone:308-346-4988
Practice Address - Fax:308-346-9103
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist