DR. Larry David Tidwell, DMD

NPI #1902905730 in Newberg, Oregon

Provider Information

NPI Number: 1902905730
Entity Type: Individual
Name: DR. Larry David Tidwell, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Sep 21, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 102 NORTH RIVER STREET
City: Newberg
State: Oregon
ZIP Code: 97132
Phone: (503) 538-2888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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