TIDEWATER DENTAL CENTER PLLC NPI 1275789950

NPI Information

TIDEWATER DENTAL CENTER, PLLC is a general practice dentist in Norfolk, VA. 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 DENTAL CENTER, PLLC NPI is 1275789950. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

425 W 20TH ST
3
NORFOLK, VA
ZIP 23517-128
Phone: (757) 622-4245
Fax: (757) 622-3722

The provider's authorized official is Amy D Ford .
The authorized official title is Vice President Of Operations and has the following contact phone number (757) 622-4245.

The enumeration date for this NPI number is 8/13/2008 and was last updated on 8/13/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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