Provider Demographics
NPI:1215112479
Name:ROENIGK, TIMOTHY KARL (DMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:KARL
Last Name:ROENIGK
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 1:2471 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4947
Mailing Address - Country:US
Mailing Address - Phone:717-244-4094
Mailing Address - Fax:717-244-9943
Practice Address - Street 1:2471 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4947
Practice Address - Country:US
Practice Address - Phone:717-244-4094
Practice Address - Fax:717-244-9943
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0369521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice