TIDEWATER DENTAL AND ASSOC INC

LEXINGTON PARK, MD
NPI1184703803
Former Legal Business NameDAVID J COOPER MICHAEL W OWENS HAE SOOK KIM
Entity TypeOrganization
Authorized ContactCONNIE M MCCABE
Financial Admin
301-862-3900
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MD  MD6466)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: MD  MD13051)
1223G0001X Dentist, General Practice
(Licence: MD  MD13931)
Enumeration Date2006-11-03
Last Update Date2008-07-01
Business Address
TIDEWATER DENTAL AND ASSOC INC
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
Phone number: 301-862-3900
Mailing Address
TIDEWATER DENTAL AND ASSOC INC
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653
Phone number: 301-862-3900