Individual
DR. JOHN K. TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1801 NW MARKET ST, SUITE 108, SEATTLE, WA 98107-3987
(206) 783-9672
(206) 784-4812
Mailing address
1801 NW MARKET ST, SUITE 108, SEATTLE, WA 98107-3987
(206) 783-9672
(206) 784-4812
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE00006884
WA
Other
Enumeration date
10/13/2006
Last updated
10/22/2013
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