Provider Demographics
NPI:1285885418
Name:TIMMS, DANIEL G (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:TIMMS
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 1:1104 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3012
Mailing Address - Country:US
Mailing Address - Phone:856-845-1200
Mailing Address - Fax:856-384-8308
Practice Address - Street 1:1104 COOPER ST
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3012
Practice Address - Country:US
Practice Address - Phone:856-845-1200
Practice Address - Fax:856-384-8308
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ100131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice