Provider Demographics
NPI:1649506924
Name:PACE, TIMOTHY C (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:C
Last Name:PACE
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 1:510 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2504
Mailing Address - Country:US
Mailing Address - Phone:615-446-4448
Mailing Address - Fax:615-740-6604
Practice Address - Street 1:510 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2504
Practice Address - Country:US
Practice Address - Phone:615-446-4448
Practice Address - Fax:615-740-6604
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS4348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist