Southern Delaware Associates of Dental Specialities
NPI #1952687360 in Rehoboth Beach, Delaware
Provider Information
- NPI Number
- 1952687360
- Entity Type
- Organization
- Organization Name
- Southern Delaware Associates of Dental Specialities
- Primary Specialty
- Clinic/Center - Oral and Maxillofacial Surgery
- Enumeration Date
- Oct 30, 2011
- Last Updated
- Oct 30, 2011
Practice Location
- Address
- 19323 LIGHTHOUSE PLAZA BLVD
- Address 2
- UNIT 4
- City
- Rehoboth Beach
- State
- Delaware
- ZIP Code
- 19971-6162
- Phone
- (215) 880-9919
Authorized Official
- Name
- OTTO TIDWELL, DDS
- Title
- OWNER
- Phone
- (215) 880-9919
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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