Individual
DR. SCOTT ALAN TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8390 W 80TH AVE, ARVADA, CO 80005-4471
(303) 425-6419
(303) 347-8912
Mailing address
7265 S LOGAN ST, CENTENNIAL, CO 80122-1149
(720) 877-1045
(303) 347-8912
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6653
CO
Other
Enumeration date
09/07/2005
Last updated
08/19/2008
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