Provider Demographics
NPI:1275647802
Name:GODSEY, TIMOTHY WATKINS (DDS, MS, PA)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WATKINS
Last Name:GODSEY
Suffix:
Gender:M
Credentials:DDS, MS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 CRESCENT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-5288
Mailing Address - Country:US
Mailing Address - Phone:919-968-1778
Mailing Address - Fax:919-408-0706
Practice Address - Street 1:150 PROVIDENCE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2208
Practice Address - Country:US
Practice Address - Phone:919-968-1778
Practice Address - Fax:919-408-0706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59101223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics