Organization
SOUTHERN DELAWARE ASSOCIATES OF DENTAL SPECIALITIES
Active
Organization
SOUTHERN DELAWARE ASSOCIATES OF DENTAL SPECIALITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTTO TIDWELL DDS (OWNER)
(215) 880-9919
Entity
Organization
Contact information
Practice address
19323 LIGHTHOUSE PLAZA BLVD, UNIT 4, REHOBOTH BEACH, DE 19971-6162
(215) 880-9919
Mailing address
19323 LIGHTHOUSE PLAZA BLVD, UNIT 4, REHOBOTH BEACH, DE 19971-6162
(215) 880-9919
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
DE
Other
Enumeration date
10/30/2011
Last updated
10/30/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up