Provider Demographics
NPI:1063186070
Name:DR. TIMOTHY D. SINES, INC
Entity type:Organization
Organization Name:DR. TIMOTHY D. SINES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SINES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-599-8250
Mailing Address - Street 1:1193 PINEVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3395
Mailing Address - Country:US
Mailing Address - Phone:304-599-8250
Mailing Address - Fax:304-599-6684
Practice Address - Street 1:1193 PINEVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3395
Practice Address - Country:US
Practice Address - Phone:304-599-8250
Practice Address - Fax:304-599-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental