Provider Demographics
NPI:1659331437
Name:MCDUFFEE, TIMOTHY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALAN
Last Name:MCDUFFEE
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 1:6865 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1501
Mailing Address - Country:US
Mailing Address - Phone:614-882-5525
Mailing Address - Fax:614-882-7456
Practice Address - Street 1:6865 OAK CREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1501
Practice Address - Country:US
Practice Address - Phone:614-882-5525
Practice Address - Fax:614-882-7456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH178111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice