Tidewater Dental Solomons Island, Llc | |
14532 Solomons Island Road Solomons Island MD 20688 | |
(301) 862-3900 | |
Not Available |
Full Name | Tidewater Dental Solomons Island, Llc |
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Speciality | Dentist - General Practice |
Location | 14532 Solomons Island Road, Solomons Island, Maryland |
Authorized Official Name and Position | David Jack Cooper (OWNER) |
Authorized Official Contact | 3018623900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Tidewater Dental Solomons Island, Llc 21534 Great Mills Rd Lexington Park MD 20653-1204 Ph: (301) 862-3900 | Tidewater Dental Solomons Island, Llc 14532 Solomons Island Road Solomons Island MD 20688 Ph: (301) 862-3900 |
NPI Number | 1982006888 |
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Provider Enumeration Date | 09/23/2014 |
Last Update Date | 09/23/2014 |
Identifier | Type | State | Issuer |
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1982006888 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | MD6466 (Maryland) | Primary |