Provider Demographics
NPI:1710026349
Name:DONLEY, TIMOTHY GERARD (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:GERARD
Last Name:DONLEY
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 US 31W BYP
Mailing Address - Street 2:SUITE #111
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4963
Mailing Address - Country:US
Mailing Address - Phone:270-842-2341
Mailing Address - Fax:
Practice Address - Street 1:727 US 31W BYP
Practice Address - Street 2:SUITE #111
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4963
Practice Address - Country:US
Practice Address - Phone:270-842-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 69671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics