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Dr. Timothy D. Supan, DMD
General Practice Dentistry in Gridley, Illinois
NPI 1053316463

Timothy D. Supan is a General Practice Dentistry based in Gridley, IL and is specialized in General Practice. Timothy D. Supan practices in Gridley, IL and has the professional credentials of DMD. The NPI Number for Timothy D. Supan is 1053316463 and holds a License No. (Illinois).

The current practice location address for Timothy D. Supan is 205 E Gridley Rd, Gridley, IL and can be reached out via phone at 309-747-2213 and via fax at 309-747-3989.

Location: 205 E Gridley Rd, Gridley, IL, 61744-0197
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053316463
Provider Name
Timothy D. Supan
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
205 E Gridley Rd, Gridley, IL, 61744-0197
Phone Number
309-747-2213
Fax Number
309-747-3989
Provider Enumeration Date
06/14/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
205 E Gridley Rd
City
Gridley
State
Illinois
Zip
61744-8733
Phone Number
309-747-2213
Fax Number
309-747-3989
person
Provider Business Mailing Address Details
Address
205 E Gridley Rd
City
Gridley
State
Illinois
Zip
61744-8733
Phone Number
309-747-2213
Fax Number
309-747-3989
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
(Illinois)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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