| Tidewater Dental Center, Pllc | |
|
425 W 20th St 3 Norfolk VA 23517-2128 | |
| (757) 622-4245 | |
| (757) 622-3722 |
| Full Name | Tidewater Dental Center, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 425 W 20th St, Norfolk, Virginia |
| Authorized Official Name and Position | Amy D Ford (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Contact | 7576224245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Dental Center, Pllc 425 W 20th St 3 Norfolk VA 23517-2128 Ph: (757) 622-4245 | Tidewater Dental Center, Pllc 425 W 20th St 3 Norfolk VA 23517-2128 Ph: (757) 622-4245 |
| NPI Number | 1275789950 |
|---|---|
| Provider Enumeration Date | 08/13/2008 |
| Last Update Date | 08/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275789950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401411261 (Virginia) | Primary |
James H Boyd Jr Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 549 E Brambleton Avenue, Ste 9, Norfolk, VA 23510 Phone: 757-623-4820 | |