Tim Micah Supin is a Dentist in Vancouver, Washington. Tim Micah Supin practices all healthcare services and medical treatments related to Dentist. The NPI Number for Tim Micah Supin is 1538362256. The last update date is 2013-07-31.
Tim Micah Supin's current location address is 1412 Ne 88th St, Vancouver, Washington. You can contact this provider via phone number 3605744074. The mailing address for Tim Micah Supin is 1412 Ne 88th St, Vancouver, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tim Micah Supin |
|---|---|
| Address | 1412 Ne 88th St, Vancouver, Washington |
| Phone Number | 3605744074 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1538362256 |
|---|---|
| Provider Enumeration Date | 2007-06-08 |
| Last Updated Date | 2013-07-31 |
Provider Mailing Address Detail
| Address | 1412 Ne 88th St |
|---|---|
| City | Vancouver |
| State | Washington (WA) |
| Post Code | 986659620 |
| Phone Number | 3605744074 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | DE00010813 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code assigned to Tim Micah Supin by the Centers for Medicare & Medicaid Services?
The Tim Micah Supin has been issued the NPI (National Provider Identifier) 1538362256, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Tim Micah Supin's facilities are geographically located?
The facilities of Tim Micah Supin are physically situated at the following location: 1412 Ne 88Th St, Vancouver, WA, 986659620.
What is Tim Micah Supin's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Tim Micah Supin's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
When was the Tim Micah Supin's 1538362256 issued?
The Tim Micah Supin's 1538362256 was issued on 2007-06-08.
As of what date were the Tim Micah Supin's details last updated?
The information pertaining to the Tim Micah Supin, including its address, specialty, and other details, was most recently updated on 2013-07-31.