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Contact Information

TIDEWATER DENTAL AND ASSOC INC
21534 GREAT MILLS RD
LEXINGTON PARK, MD20653
 Phone: 301-862-3900
 Fax: 301-862-3779
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for TIDEWATER DENTAL AND ASSOC INC · (Female)

NPI Number 1184703803
Status Active
Credentials
Entity Individual
Enumeration date 11/03/2006
Last updated 07/01/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MD License # MD13051
  • MD License # MD13931
  • MD License # MD6466
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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