Provider Demographics
NPI:1952464232
Name:GUNNIN, TIMOTHY DAVIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DAVIS
Last Name:GUNNIN
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 1:110 SOUTH HASSON ST
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857
Mailing Address - Country:US
Mailing Address - Phone:423-272-5353
Mailing Address - Fax:423-272-0047
Practice Address - Street 1:110 SOUTH HASSON ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857
Practice Address - Country:US
Practice Address - Phone:423-272-5353
Practice Address - Fax:423-272-0047
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist