Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. AUSTIN TIDWELL, DMD
Active Sole ProprietorDR. AUSTIN TIDWELL, DMD is a Pediatric Dentistry healthcare provider located in PLEASANT GROVE, Utah. NPI 1265059091 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · PLEASANT GROVE, UT
Registration Details
- NPI Number
- 1265059091
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 27, 2020 (6.1482001207241 yrs)
- Last Updated
- Jun 28, 2022
- Licenses
-
7421 (NV)LL-538-20 (NV)12772511-9922 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1082N N NORTHCOUNTY BLVDPLEASANT GROVE, UT, 840623400Browse UT providers · Browse ZIP 84062
- Phone
- 8017566048
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- General Dentistry
- Additional Specialty
- Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.