Provider Demographics
NPI:1316077704
Name:MCNUTT, SR., TIMOTHY ELVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ELVIN
Last Name:MCNUTT, SR.
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3817 BEDFORD AVE.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215
Mailing Address - Country:US
Mailing Address - Phone:615-383-0171
Mailing Address - Fax:615-383-8378
Practice Address - Street 1:3817 BEDFORD AVE.
Practice Address - Street 2:SUITE 120
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-383-0171
Practice Address - Fax:615-383-8378
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry