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1639223043
GREGG CARRINGTON TIDWELL
MONROE, LA
NPI
1639223043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 3793)
Enumeration Date
2007-01-23
Last Update Date
2007-07-09
Business Address
Dr. GREGG CARRINGTON TIDWELL D.D.S.
1512 ROYAL AVE
MONROE, LA 71201-5610
Phone number: 318-387-5400
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Mailing Address
Dr. GREGG CARRINGTON TIDWELL D.D.S.
1512 ROYAL AVE
MONROE, LA 71201-5610
Phone number: 318-387-5400
Copy
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