DR. Bill Shayne Tidwell, DDS

NPI #1053391797 in Fort Defiance, Arizona

Provider Information

NPI Number
1053391797
Entity Type
Individual
Name
DR. Bill Shayne Tidwell, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Jan 19, 2006
Last Updated
Oct 18, 2019

Practice Location

Address
CORNER OF ROUTE N12 AND N7
State
Arizona
ZIP Code
86504-0589
Phone
(928) 729-8000

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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