Dr. Timothy J Clegg
Oral and Maxillofacial Surgeon
36975 Utica Rd Suite 106
Clinton Twp
, Michigan 48036-1685
Dr. Timothy J Clegg
Oral and Maxillofacial Surgeon
36975 Utica Rd Suite 106
Clinton Twp
, Michigan 48036-1685
(586) 226-1519
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Timothy J Clegg
- 36975 Utica Rd Suite 106
- Clinton Twp, MI
- Zip : 48036-1685
- Fax : (586) 226-1519
- Phone : (586) 226-2801
Second Address
- Dr. Timothy J Clegg
- 36975 Utica Rd Suite 106
- Clinton Twp, MI
- Zip : 48036-1685
- Fax : (586) 226-0929
- Phone : (586) 226-2801
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 012043 | MI |
National Provider Identifier
| NPI | 1104819515 |
|---|---|
| Provider Name | Dr. Timothy J Clegg |
| First Address | Clinton Twp, MI 48036-1685 |
| Second Address | Clinton Twp, MI 48036-1685 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2005 |
| Last Update Date | 12/09/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U21482 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.