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Dr. Otto Frederick Tidwell, DDS
Oral and Maxillofacial Surgery (Dentist) in Rehoboth Beach, Delaware
NPI 1407803398

Otto Frederick Tidwell is a Oral and Maxillofacial Surgery (Dentist) based in Rehoboth Beach, DE and is specialized in Oral and Maxillofacial Surgery. Otto Frederick Tidwell practices in Rehoboth Beach, DE and has the professional credentials of DDS. The NPI Number for Otto Frederick Tidwell is 1407803398 and holds a License No. DS022622L (Delaware).

The current practice location address for Otto Frederick Tidwell is 19323 Lighthouse Plaza Blvd, Rehoboth Beach, DE and can be reached out via phone at 302-226-1606 and via fax at 302-226-1609.

Location: 19323 Lighthouse Plaza Blvd, Rehoboth Beach, DE, 19971-6162
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Provider Profile Details
NPI Number
1407803398
Provider Name
Otto Frederick Tidwell
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
19323 Lighthouse Plaza Blvd, Rehoboth Beach, DE, 19971-6162
Phone Number
302-226-1606
Fax Number
302-226-1609
Provider Enumeration Date
05/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0060881000 01 PA BLUE CROSS PROVIDER NUMBE
121367 01 PA UNITED CONCORDIA PROVIDER
institution
Provider Business Practice Location Address Details
Address
19323 Lighthouse Plaza Blvd
City
State
Zip
19971-6162
Phone Number
302-226-1606
Fax Number
302-226-1609
person
Provider Business Mailing Address Details
Address
19323 Lighthouse Plaza Blvd
City
State
Zip
19971-6162
Phone Number
302-226-1606
Fax Number
302-226-1609
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
DS022622L (Pennsylvania)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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