Provider Demographics
NPI:1245371780
Name:OVERBY, TIMOTHY P (DMD LTD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:P
Last Name:OVERBY
Suffix:
Gender:M
Credentials:DMD LTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20841 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7216
Mailing Address - Country:US
Mailing Address - Phone:434-239-8907
Mailing Address - Fax:434-239-4883
Practice Address - Street 1:20841 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7216
Practice Address - Country:US
Practice Address - Phone:434-239-8907
Practice Address - Fax:434-239-4883
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010085761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice