Provider Demographics
NPI:1801275961
Name:DOWNING, TIMOTHY ALDRICH (DDS)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALDRICH
Last Name:DOWNING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:IN
Mailing Address - Zip Code:47944
Mailing Address - Country:US
Mailing Address - Phone:765-884-0740
Mailing Address - Fax:765-884-9046
Practice Address - Street 1:809 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:IN
Practice Address - Zip Code:47944
Practice Address - Country:US
Practice Address - Phone:765-884-0740
Practice Address - Fax:765-884-9046
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012300A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist