TIDEWATER LLC is a general practice dentist in Charlotte Hall, MD. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. TIDEWATER LLC NPI is 1144884560. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
30320 TRIANGLE DR
CHARLOTTE HALL, MD
ZIP 20622-109
Phone: (301) 359-1717
Fax: (301) 359-1719
The provider's authorized official is Simone Wilson .
The authorized official title is Director Of Credentialing & Enroll and has the following contact phone number (848) 326-8840.
The enumeration date for this NPI number is 5/1/2019 and was last updated on 5/2/2023.