Tidewater Llc is a Dental Clinic in Charlotte Hall, Maryland. This organization is also known as sub part of Tidewater, Llc. It is located at 30320 Triangle Dr, Charlotte Hall, MD and its contact number is 301-359-1717. The authorized person for Tidewater Llc is Simone Wilson
who is Director Of Credentialing & Enroll of the clinic and their contact number is 848-326-8840.
Tidewater Llc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Tidewater Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Tidewater Llc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 30320 Triangle Dr, Charlotte Hall,
Maryland, 20622-4109 |
| Phone: | 301-359-1717 |
| Fax: | 301-359-1719 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Simone Wilson |
| Position: | Director Of Credentialing & Enroll |
| Contact Number: | 848-326-8840 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Tidewater Llc clinic are as mentioned below.
| NPI Number: | 1144884560 |
| Parent Organization: | Tidewater, Llc |
| NPI Enumeration Date: | 01 May, 2019 |
| NPI Last Update On: | 02 May, 2023 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Tidewater Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | | | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Tidewater Llc
21534 Great Mills Rd,
Lexington Park, Maryland |
| Zip: | 20653-1204 |
| Phone Number: | -- |
| Fax Number: | -- |
Patients can reach Tidewater Llc at
30320 Triangle Dr, Charlotte Hall, Maryland or can
call to book an appointment on 301-359-1717.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.