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TIDEWATER LLC NPI 1437643384


NPI Information

NPI: 1437643384
Provider Name: TIDEWATER LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
10113 WARD RD
DUNKIRK, MD
ZIP 20754
Phone: (301) 327-3314
Get Directions

TIDEWATER LLC is a general practice dentist in Dunkirk, 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 1437643384. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10113 WARD RD
DUNKIRK, MD
ZIP 20754-717
Phone: (301) 327-3314
Fax: (301) 327-3315

The provider's authorized official is David Cooper .
The authorized official title is Owner and has the following contact phone number (301) 862-3900.

The enumeration date for this NPI number is 6/14/2018 and was last updated on 6/14/2018.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeMARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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