Provider Demographics
NPI:1437271947
Name:TIMLIN, SCOTT A (DDS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:TIMLIN
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 1:2200 E 104TH AVE
Mailing Address - Street 2:#112
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4404
Mailing Address - Country:US
Mailing Address - Phone:303-452-4142
Mailing Address - Fax:303-254-8360
Practice Address - Street 1:2200 E 104TH AVE
Practice Address - Street 2:#112
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4404
Practice Address - Country:US
Practice Address - Phone:303-452-4142
Practice Address - Fax:303-254-8360
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO78631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice