Provider Demographics
NPI:1952502890
Name:SWEET, TIMOTHY PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:SWEET
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 1:5291 W TAFT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-2744
Mailing Address - Country:US
Mailing Address - Phone:315-458-2790
Mailing Address - Fax:315-458-2791
Practice Address - Street 1:5291 W TAFT RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2744
Practice Address - Country:US
Practice Address - Phone:315-458-2790
Practice Address - Fax:315-458-2791
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040052-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice