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Dr. Eric Ivan Tidwell, DDS
General Practice Dentistry in Provo, Utah
NPI 1932131562

Eric Ivan Tidwell is a General Practice Dentistry based in Provo, UT and is specialized in General Practice. Eric Ivan Tidwell practices in Provo, UT and has the professional credentials of DDS. The NPI Number for Eric Ivan Tidwell is 1932131562 and holds a License No. 145165 (Utah).

The current practice location address for Eric Ivan Tidwell is 777 N 500 W Ste 101A, Provo, UT and can be reached out via phone at 801-373-6362 and via fax at 801-373-0115.

Location: 777 N 500 W Ste 101A, Provo, UT, 84601-1594
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932131562
Provider Name
Eric Ivan Tidwell
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
777 N 500 W Ste 101A, Provo, UT, 84601-1594
Phone Number
801-373-6362
Fax Number
801-373-0115
Provider Enumeration Date
07/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
25762 01 UT PUBLIC EMPLOYEES HEALTH
0005877274 01 UT AETN
145165UT 01 UT DELTA
23820 01 UT DESERET MUTUAL
institution
Provider Business Practice Location Address Details
Address
777 N 500 W Ste 101A
City
Provo
State
Utah
Zip
84601-1594
Phone Number
801-373-6362
Fax Number
801-373-0115
person
Provider Business Mailing Address Details
Address
777 N 500 W Ste 101A
City
Provo
State
Utah
Zip
84601-1594
Phone Number
801-373-6362
Fax Number
801-373-0115
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
145165 (Utah)
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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