Mcconnell, Timothy Ivan

Mcconnell, Timothy Ivan is an individual health care provider with primary practice located at 100 Berkeley Square Ln , Goose Creek SC 29445-2958. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mcconnell, Timothy Ivan can be contacted via phone (843) 553-5235.

Contact Information

Primary practice address
100 Berkeley Square Ln Goose Creek SC 29445-2958
Phone: (843) 553-5235
Fax: (843) 797-8189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1759 South Carolina

Profile Details

NPI number 1235187501
LBN Legal business name Mcconnell, Timothy Ivan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235187501 NPPES
South Carolina MEDICAID Z17599
South Carolina Other 79343

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