Provider Demographics
NPI:1508967324
Name:DOWD, TIMOTHY MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MICHAEL
Last Name:DOWD
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 912
Mailing Address - Street 2:
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439
Mailing Address - Country:US
Mailing Address - Phone:843-588-9556
Mailing Address - Fax:
Practice Address - Street 1:109 BEE STREET
Practice Address - Street 2:DENTAL SERVICE 160
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29439
Practice Address - Country:US
Practice Address - Phone:843-789-6161
Practice Address - Fax:843-789-6014
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYD-0414301223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics