Provider Demographics
NPI:1710101878
Name:HERRING, TIMOTHY G (DMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:G
Last Name:HERRING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 S OSPREY AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2920
Mailing Address - Country:US
Mailing Address - Phone:941-366-3894
Mailing Address - Fax:941-955-7235
Practice Address - Street 1:1445 S OSPREY AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2920
Practice Address - Country:US
Practice Address - Phone:941-366-3894
Practice Address - Fax:941-955-7235
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10304122300000X
AL3939122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist