Provider Demographics
NPI:1538444948
Name:TIMOTHY J. MOLLOY, D.D.S.
Entity type:Organization
Organization Name:TIMOTHY J. MOLLOY, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOLLOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-482-7252
Mailing Address - Street 1:413 EAST PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546
Mailing Address - Country:US
Mailing Address - Phone:281-482-7252
Mailing Address - Fax:
Practice Address - Street 1:413 E PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5149
Practice Address - Country:US
Practice Address - Phone:281-482-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental