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1306359054
TIDEWATER LLC
PRINCE FREDERICK, MD
NPI
1306359054
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Entity Type
Organization
Authorized Contact
DAVID COOPER
Owner
301-862-3900
Organization Subpart ?
Yes
Primary Taxonomy
122300000X Dentist
Enumeration Date
2017-11-15
Last Update Date
2017-11-15
Business Address
TIDEWATER LLC
700 PRINCE FREDERICK BLVD
PRINCE FREDERICK, MD 20678-3141
Phone number: 410-414-8333
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Mailing Address
TIDEWATER LLC
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653-1204
Phone number: 301-862-3900
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