MICHAEL TIDWELL

DAYTONA BEACH, FL
NPI1518954924
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  DN0007338)
Enumeration Date2005-09-30
Last Update Date2007-07-08
Business Address
-- MICHAEL TIDWELL DMD
350 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114-2733
Phone number: 386-238-3280
Mailing Address
-- MICHAEL TIDWELL DMD
PO BOX 9671
DAYTONA BEACH, FL 32120-9671
Phone number: 386-676-7130
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