Provider Demographics
NPI:1265639439
Name:TIMOTHY L. MCKINNEY DDS P.C.
Entity Type:Organization
Organization Name:TIMOTHY L. MCKINNEY DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-625-6456
Mailing Address - Street 1:169 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6971
Mailing Address - Country:US
Mailing Address - Phone:603-625-6456
Mailing Address - Fax:603-627-6556
Practice Address - Street 1:169 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6971
Practice Address - Country:US
Practice Address - Phone:603-625-6456
Practice Address - Fax:603-627-6556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH21631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2163OtherLICENSE
NH1467514364OtherNPI TYPE I
NHZZ1663OtherBCBS MA PROVIDER ID NO.
NHZZ1663OtherBCBS MA PROVIDER ID NO.