Provider Demographics
NPI:1003337288
Name:AHERN, TIMOTHY STEPHEN (DMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:STEPHEN
Last Name:AHERN
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 1:1 HAMPTON RD UNIT 305
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4891
Mailing Address - Country:US
Mailing Address - Phone:603-583-4533
Mailing Address - Fax:
Practice Address - Street 1:1 HAMPTON RD UNIT 305
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4891
Practice Address - Country:US
Practice Address - Phone:603-583-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice