TIDEWATER LLC

GLEN BURNIE, MD
NPI1760171060
Entity TypeOrganization
Authorized ContactSIMONE WILSON-ADELEKE
Director Of Credentialing & Enroll
848-326-8840
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2023-05-02
Last Update Date2023-05-02
Business Address
TIDEWATER LLC
1720 CRAIN HWY S STE 103
GLEN BURNIE, MD 21061-5631
Phone number: 410-761-0095
Mailing Address
TIDEWATER LLC
21534 GREAT MILLS RD
LEXINGTON PARK, MD 20653-1204
Phone number: 301-862-3900
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