Timothy Wayne Holmes, D.D.S.
Individual provider Active NPI General Practice Dentistry · Piedmont, MO
NPI 1629291364 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629291364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- MO015039 (MO)
- Practice address
- 100 S Main St
Piedmont, MO 63957-1563 - Phone
- (573) 223-4513
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO015039 | MO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | MO015039 | MO | Yes |
Addresses
Primary practice location
100 S Main St
Piedmont, MO 63957-1563
Mailing address
100 S Main St
Piedmont, MO 63957-1563
Phone (573) 223-4513
Other providers in Piedmont, MO
- Hillis Family Chiropractic LLC
- Timothy John Hillis
- Stacie Hoagland
- Matthew Scott Hodges
- Kelsey Holder
- Emily Elaine Hughes
- Mary Hutchison
- Ashley Dawn Janecek
- Teresa Gayle Johnson
- Pamela Sue Johnston
All providers in Piedmont, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.