Dr Timothy D Supan, DMD | |
205 E Gridley Rd, Gridley, IL 61744-8733 | |
(309) 747-2213 | |
(309) 747-3989 |
Full Name | Dr Timothy D Supan |
---|---|
Gender | Male |
Speciality | Dentist - General Practice |
Location | 205 E Gridley Rd, Gridley, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053316463 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (Illinois) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Timothy D Supan, DMD Po Box 197, Gridley, IL 61744-0197 Ph: (309) 747-2213 | Dr Timothy D Supan, DMD 205 E Gridley Rd, Gridley, IL 61744-8733 Ph: (309) 747-2213 |
Dr. Stephen T. Blue, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 205 E Gridley Rd, Gridley, IL 61744 Phone: 309-747-2213 Fax: 309-747-3989 | |
Dr. Charles L. Proesel Jr., D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 205 E Gridley Rd, Gridley, IL 61744 Phone: 309-747-2213 Fax: 309-747-3989 |