Tidewater LLC
Tidewater LLC is a General Practice Dentistry in Charlotte Hall, Maryland. Registered with an NPI since 2019.
- In the registry since
- 2019
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
30320 Triangle DrCharlotte Hall, MD 20622-4109
Phone: (301) 359-1717
Fax: (301) 359-1719
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X |
|---|
Record details
| NPI number | 1144884560 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Tidewater, LLC |
| Authorized official | Simone Wilson — Director Of Credentialing & Enroll · (848) 326-8840 |
| NPI enumerated | May 1, 2019 |
| Last updated in NPPES | May 2, 2023 |
| Certification date | May 2, 2023 |
| Mailing address | 21534 Great Mills Rd, Lexington Park, MD 20653-1204 |
Other providers in Charlotte Hall
-
Dr. Dana Kim, DMD
29795 Three Notch Rd, Charlotte Hall, MD 20622 · (301) 290-0001
-
Dr. Hae Sook Kim, DMD
29795 Three Notch Rd, Charlotte Hall, MD 20622 · (301) 290-0001
-
Thomas O'Shea
37601 Golden Beach Rd, Charlotte Hall, MD 20622-3060 · (301) 884-2299
-
Corinne Ellen Tabert, DDS
29795 Three Notch Rd, Charlotte Hall, MD 20622-4106 · (301) 290-0001