Dr. Tim Gough, DDS
Dentist in Parkville, MD. Individual provider (NPI-1).
NPI number1104483791
StatusActive
Last updated in NPPESNov 22, 2019
Details
- NPI
- 1104483791
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tim Gough
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 20, 2019
- Last updated
- Nov 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 17197 | MD | Yes |
Practice location
9010 Harford RdParkville, MD 21234-4033
Phone 410-665-2202 · Fax 410-665-9008
Mailing address
2410 Ravenview RdTimonium, MD 21093-2716
Phone 410-252-3526
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All 11 Dentist providers in Parkville · All 638 providers in Parkville
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