Tidewater Dental and Assoc INC
NPI #1184703803 in Lexington Park, Maryland
Provider Information
- NPI Number
- 1184703803
- Entity Type
- Organization
- Organization Name
- Tidewater Dental and Assoc INC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 3, 2006
- Last Updated
- Jul 1, 2008
Practice Location
- Address
- 21534 GREAT MILLS RD
- City
- Lexington Park
- State
- Maryland
- ZIP Code
- 20653
- Phone
- (301) 862-3900
Authorized Official
- Name
- MRS. CONNIE M MCCABE
- Title
- FINANCIAL ADMIN
- Phone
- (301) 862-3900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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