Timothy J Sills, DMD
Individual provider Active NPI General Practice Dentistry · Old Monroe, MO
NPI 1821115940 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821115940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 15083 (MO)
- Practice address
- 102 Locust St
Old Monroe, MO 63369 - Phone
- (636) 661-5205
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 15083 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timothy J. Sills DMD PC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15083 | MO | Yes |
Addresses
Primary practice location
102 Locust St
Old Monroe, MO 63369
Mailing address
102 Locust Street
P O Box 47
Old Monroe, MO 63369
Phone (636) 661-5205
Other providers in Old Monroe, MO
- Fayth Nikole Abel
- Alexandra Klamm
- Kathleen Elizabeth McCoy
- Abigail Ortego
- Sara Springer
- Timothy J. Sills DMD PC
- Amelia J Titone
All providers in Old Monroe, 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.