| Tidewater Llc | |
|
10113 Ward Rd Dunkirk MD 20754-2717 | |
| (301) 327-3314 | |
| (301) 327-3315 |
| Full Name | Tidewater Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10113 Ward Rd, Dunkirk, Maryland |
| Authorized Official Name and Position | David Cooper (OWNER) |
| Authorized Official Contact | 3018623900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Llc 21534 Great Mills Rd Lexington Park MD 20653-1204 Ph: (301) 862-3900 | Tidewater Llc 10113 Ward Rd Dunkirk MD 20754-2717 Ph: (301) 327-3314 |
| NPI Number | 1437643384 |
|---|---|
| Provider Enumeration Date | 06/14/2018 |
| Last Update Date | 06/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437643384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Maryland) | Primary |
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