Dr. Timothy Patrick Walsh, DDS
Dentist, Periodontics in Berwyn, IL. Individual provider (NPI-1).
NPI number1720161896
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720161896
- Entity type
- Individual (NPI-1)
- Name
- Dr. Timothy Patrick Walsh
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 23, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | 021001113 | IL | Yes |
Practice location
6901 W Stanley AvenueBerwyn, IL 60402
Phone 708-749-4080 · Fax 708-749-0835
Mailing address
6901 W Stanley AvenueBerwyn, IL 60402
Phone 708-749-4080 · Fax 708-749-0835
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