Larry David Tidwell in Newberg - Dentist
Larry David Tidwell - NPI 1902905730
Larry David Tidwell is a Dentist in Newberg, Oregon. Larry David Tidwell practices all healthcare services and medical treatments related to Dentist. The NPI Number for Larry David Tidwell is 1902905730. The last update date is 2007-07-08.
Larry David Tidwell's current location address is 102 North River Street, Newberg, Oregon. You can contact this provider via phone number 5035382888 and fax number 5035281255. The mailing address for Larry David Tidwell is 102 North River Street, Newberg, Oregon. To know further, please read the information below!
Provider Profile Detail
Provider Name | Larry David Tidwell |
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Address | 102 North River Street, Newberg, Oregon |
Phone Number | 5035382888 |
Fax Number | 5035281255 |
Sole Proprietor | N |
Credentials | DMD |
NPI Number Detail
NPI Number | 1902905730 |
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Provider Enumeration Date | 2006-09-21 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 102 North River Street |
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City | Newberg |
State | Oregon (OR) |
Post Code | 97132 |
Phone Number | 5035382888 |
Fax Number | 5035281255 |
Provider's Primary Taxonomy Detail
Speciality | Dentist |
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Taxonomy | 122300000X |
Licence No | D5668 |
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique identification code assigned to Larry David Tidwell by the Centers for Medicare & Medicaid Services?
The Larry David Tidwell has been issued the NPI (National Provider Identifier) 1902905730. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Larry David Tidwell is geographically located?
The Larry David Tidwell is physically situated at the following location: 102 North River Street, Newberg, OR, 97132.
What is Larry David Tidwell's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Larry David Tidwell's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Larry David Tidwell receive its 1902905730 assignment from the Centers for Medicare & Medicaid Services?
The Larry David Tidwell was assigned its 1902905730 by the Centers for Medicare & Medicaid Services on 2006-09-21.
As of what date were the Larry David Tidwell's details last updated?
The information pertaining to the Larry David Tidwell, including its address, specialty, and other details, was most recently updated on 2007-07-08.