| Tidewater Dental Lusby | |
|
10025 Hg Trueman Road Lusby MD 20657 | |
| (301) 862-3900 | |
| Not Available |
| Full Name | Tidewater Dental Lusby |
|---|---|
| Speciality | Dentist |
| Location | 10025 Hg Trueman Road, Lusby, Maryland |
| Authorized Official Name and Position | David Jack Cooper (OWNER) |
| Authorized Official Contact | 4103264078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Dental Lusby 10025 Hg Trueman Rd Lusby MD 20657-2868 Ph: (410) 326-4078 | Tidewater Dental Lusby 10025 Hg Trueman Road Lusby MD 20657 Ph: (301) 862-3900 |
| NPI Number | 1386009405 |
|---|---|
| Provider Enumeration Date | 12/16/2015 |
| Last Update Date | 03/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386009405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Calvert Community Dental Care - Lusby Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11840 Hg Trueman Rd, Lusby, MD 20657 Phone: 410-535-8402 Fax: 410-535-8397 | |
Dr. Jack Ursic, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10025 Hg Trueman Rd, Lusby, MD 20657 Phone: 410-326-4078 Fax: 410-326-9311 |