| Tidewater Dental Solomons Island, Llc | |
|
14532 Solomons Island Road Solomons Island MD 20688 | |
| (301) 862-3900 | |
| Not Available |
| Full Name | Tidewater Dental Solomons Island, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14532 Solomons Island Road, Solomons Island, Maryland |
| Authorized Official Name and Position | David Jack Cooper (OWNER) |
| Authorized Official Contact | 3018623900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Dental Solomons Island, Llc 21534 Great Mills Rd Lexington Park MD 20653-1204 Ph: (301) 862-3900 | Tidewater Dental Solomons Island, Llc 14532 Solomons Island Road Solomons Island MD 20688 Ph: (301) 862-3900 |
| NPI Number | 1982006888 |
|---|---|
| Provider Enumeration Date | 09/23/2014 |
| Last Update Date | 09/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982006888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | MD6466 (Maryland) | Primary |