Provider Demographics
NPI:1538224464
Name:TIMOTHY D. GUNNIN, D.D.S., P.C.
Entity type:Organization
Organization Name:TIMOTHY D. GUNNIN, D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:PEAVLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-272-5353
Mailing Address - Street 1:110 SOUTH HASSON STREET
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857
Mailing Address - Country:US
Mailing Address - Phone:423-272-5353
Mailing Address - Fax:423-272-0047
Practice Address - Street 1:110 SOUTH HASSON STREET
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857
Practice Address - Country:US
Practice Address - Phone:423-272-5353
Practice Address - Fax:423-272-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty