DR. Austin Tidwell, DMD

NPI #1265059091 in Pleasant Grove, Utah

Provider Information

NPI Number: 1265059091
Entity Type: Individual
Name: DR. Austin Tidwell, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Pediatric Dentistry
Credential: DMD
Enumeration Date: Jun 27, 2020
Last Updated: Jun 28, 2022

Practice Location

Address: 1082N N NORTHCOUNTY BLVD
City: Pleasant Grove
State: Utah
ZIP Code: 84062-3400
Phone: (801) 756-6048

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X	Primary

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Organizations

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