Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Tidewater LLC

Organization Dentist · NPI 1306359054

Tidewater LLC provides Dentist services 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.

See every abbreviation used in this directory →

Practice location Address checks out

700 Prince Frederick Blvd
Prince Frederick, MD 20678-3141
Phone: (410) 414-8333
Fax: (240) 652-8797
Show map & directions

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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