Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. OTTO FREDERICK TIDWELL, D.D.S.
Active Sole ProprietorDR. OTTO FREDERICK TIDWELL, D.D.S. is a Oral & Maxillofacial Surgery healthcare provider located in REHOBOTH BEACH, Delaware. NPI 1407803398 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · REHOBOTH BEACH, DE
Registration Details
- NPI Number
- 1407803398
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 27, 2006 (20.193667336454 yrs)
- Last Updated
- Jan 14, 2014
- Licenses
-
DS022622L (PA)22DIO1475500 (NJ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
19323 LIGHTHOUSE PLAZA BLVDUNIT 4REHOBOTH BEACH, DE, 199716162Browse DE providers · Browse ZIP 19971
- Phone
- 3022261606
- Fax
- 3022261609
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
Other Oral & Maxillofacial Surgery Providers in REHOBOTH BEACH, DE
| Name | Credential | NPI |
|---|---|---|
| DR. FRANK FALCONE JR. | D.M.D. | 1497774905 |
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.