Tidal Smiles Pediatric Dentistry PLLC
Dentist, Pediatric Dentistry in Chesapeake, VA. Organization (NPI-2).
NPI number1548782873
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1548782873
- Entity type
- Organization (NPI-2)
- Legal business name
- Tidal Smiles Pediatric Dentistry PLLC
- Organization subpart
- No
- Enumeration date
- Jul 7, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Practice location
350 Johnstown Rd Ste CChesapeake, VA 23322-5365
Phone 757-482-4777
Mailing address
350 Johnstown Rd Ste CChesapeake, VA 23322-5365
Phone 757-482-4777
Authorized official
Daniel Luke Winter
Pediatric Dentist, Owner
7574824777
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