Provider Demographics
NPI:1154521193
Name:MILLWARD, TIMOTHY (DMD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:MILLWARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 NORTHERN WAY STE G
Mailing Address - Street 2:STE. G
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3880
Mailing Address - Country:US
Mailing Address - Phone:407-365-6691
Mailing Address - Fax:407-971-9330
Practice Address - Street 1:890 NORTHERN WAY STE G
Practice Address - Street 2:STE. G
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3880
Practice Address - Country:US
Practice Address - Phone:407-365-6691
Practice Address - Fax:407-971-9330
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist