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Dr. Bill Shayne Tidwell, DDS
General Practice Dentistry in Fort Defiance, Arizona
NPI 1053391797

Bill Shayne Tidwell is a General Practice Dentistry based in Fort Defiance, AZ and is specialized in General Practice. Bill Shayne Tidwell practices in Fort Defiance, AZ and has the professional credentials of DDS. The NPI Number for Bill Shayne Tidwell is 1053391797 and holds a License No. 117592 (Arizona).

The current practice location address for Bill Shayne Tidwell is Corner Of Route N12 And N7, Fort Defiance, AZ and can be reached out via phone at 928-729-8000.

Location: Corner Of Route N12 And N7, Fort Defiance, AZ, 86504-1801
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053391797
Provider Name
Bill Shayne Tidwell
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
Corner Of Route N12 And N7, Fort Defiance, AZ, 86504-1801
Phone Number
928-729-8000
Fax Number
Provider Enumeration Date
01/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100454590A 05 KS
48-1181104 01 FEDERAL EMPLOYER NUMBER
institution
Provider Business Practice Location Address Details
Address
Corner Of Route N12 And N7
City
Fort Defiance
State
Arizona
Zip
86504-0589
Phone Number
928-729-8000
Fax Number
person
Provider Business Mailing Address Details
Address
Corner Of Route N12 And N7
City
Fort Defiance
State
Arizona
Zip
86504-0589
Phone Number
928-729-8000
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
117592 (Alaska)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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