LARRY DAVID TIDWELL

NEWBERG, OR
NPI1902905730
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: OR  D5668)
Enumeration Date2006-09-21
Last Update Date2007-07-08
Business Address
Dr. LARRY DAVID TIDWELL DMD
102 NORTH RIVER STREET
NEWBERG, OR 97132
Phone number: 503-538-2888
Mailing Address
Dr. LARRY DAVID TIDWELL DMD
102 NORTH RIVER STREET
NEWBERG, OR 97132
Phone number: 503-538-2888