Provider Demographics
NPI:1922135417
Name:HARBIN, TIMOTHY MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MARTIN
Last Name:HARBIN
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 1:785 E-M32 HWY
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735
Mailing Address - Country:US
Mailing Address - Phone:989-448-2664
Mailing Address - Fax:989-448-2666
Practice Address - Street 1:785 E M 32
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-8790
Practice Address - Country:US
Practice Address - Phone:989-448-2664
Practice Address - Fax:989-448-2666
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010169391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice