Provider Demographics
NPI:1447518972
Name:DUNCAN, TIFFANY TODD (DMD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:TODD
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MALL RD
Mailing Address - Street 2:STE B
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4079
Mailing Address - Country:US
Mailing Address - Phone:606-237-0073
Mailing Address - Fax:
Practice Address - Street 1:822 PARIS RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-2743
Practice Address - Country:US
Practice Address - Phone:270-247-0751
Practice Address - Fax:270-247-0757
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY76541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice