Individual
DR. ANTHONY C. TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4110 HIGHLAND DR, SUITE #200, SALT LAKE CITY, UT 84124-2676
(801) 278-1164
(801) 274-0124
Mailing address
4110 HIGHLAND DR, SUITE #200, SALT LAKE CITY, UT 84124-2676
(801) 278-1164
(801) 274-0124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
142661
UT
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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