Provider Demographics
NPI:1043211501
Name:TINKER, TIMOTHY BRIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BRIAN
Last Name:TINKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 561 BOX 559
Mailing Address - Street 2:
Mailing Address - City:FPO AP
Mailing Address - State:IWAKUNI
Mailing Address - Zip Code:96310-0019
Mailing Address - Country:JP
Mailing Address - Phone:011-818-2779
Mailing Address - Fax:
Practice Address - Street 1:PSC 561 BOX 1864
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:IWAKUNI
Practice Address - Zip Code:96310-0019
Practice Address - Country:JP
Practice Address - Phone:011-818-2779
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY67581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice