Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tidewater LLC

Organization Dentist · NPI 1306359054

Tidewater LLC is a Dentist in Prince Frederick, Maryland. Licensed in Maryland. Registered with an NPI since 2017.

Licensed in
MD
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

700 Prince Frederick Blvd
Prince Frederick, MD 20678-3141
Phone: (410) 414-8333
Fax: (240) 652-8797
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X (MD)

Record details

NPI number1306359054
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationTidewater LLC
Authorized official David Cooper — Owner · (301) 862-3900
NPI enumeratedNovember 15, 2017
Last updated in NPPESNovember 15, 2017
Mailing address21534 Great Mills Rd, Lexington Park, MD 20653-1204

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