Dr. Eric Ivan Tidwell is a Provo, Utah based Dentist who is specialized in General Practice Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Eric Ivan Tidwell is 145165 for General Practice Dentistry in Utah. His current practice location is 777 N 500 W Ste 101a, Provo. Patients can reach him at 801-373-6362.
Dr. Eric Ivan Tidwell is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Eric Ivan Tidwell speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Dr. Eric Ivan Tidwell
Specialization:
Dentist
Gender:
Male
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
777 N 500 W Ste 101a, Provo, Utah, 84601-1594
Phone:
801-373-6362
Fax:
801-373-0115
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 are as mentioned below.
NPI Number:
1932131562
NPI Enumeration Date:
06 Jul, 2006
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Eric Ivan Tidwell are as mentioned below.
License Number
Specialization
State
Status
145165
General Practice Dentistry
Utah
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Eric Ivan Tidwell such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
25762
Other
Utah
PUBLIC EMPLOYEES HEALTH
0005877274
Other
Utah
AETN
145165UT
Other
Utah
DELTA
23820
Other
Utah
DESERET MUTUAL
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
777 N 500 W Ste 101a, Provo, Utah
Zip:
84601-1594
Phone Number:
801-373-6362
Fax Number:
801-373-0115
Patients can reach Dr. Eric Ivan Tidwell at 777 N 500 W Ste 101a, Provo, Utah or can call to book an appointment on 801-373-6362. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.