Organization
TLDM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON THIEDE (PRACTICE MANAGER)
(727) 709-1188
Entity
Organization
Contact information
Practice address
3003 ENTERPRISE RD E, CLEARWATER, FL 33759-1304
(727) 799-4492
Mailing address
2711 TAMPA RD, PALM HARBOR, FL 34684-3312
(727) 709-1188
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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