Individual
DR. JOEL RAY TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5897 STEWART PKWY, DOUGLASVILLE, GA 30135-2373
(770) 949-1821
(770) 942-2837
Mailing address
5897 STEWART PKWY, DOUGLASVILLE, GA 30135-2373
(770) 949-1821
(770) 942-2837
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009481
GA
Other
Enumeration date
01/26/2007
Last updated
12/15/2022
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