Provider Demographics
NPI:1043317555
Name:ISABEL, TIMOTHY D (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:D
Last Name:ISABEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PICKERING ST
Mailing Address - Street 2:PO BOX 396
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929
Mailing Address - Country:US
Mailing Address - Phone:978-768-6525
Mailing Address - Fax:978-768-6525
Practice Address - Street 1:9 PICKERING ST
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MA
Practice Address - Zip Code:01929
Practice Address - Country:US
Practice Address - Phone:978-768-6525
Practice Address - Fax:978-768-6525
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice