Eric Ivan Tidwell, DDS

General Practice Dentistry · Provo, UT

Individual Active NPI

NPI number 1932131562

Practice location

777 N 500 W Ste 101a
Provo, UT 84601-1594
Phone
(801) 373-6362
Fax
(801) 373-0115

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NPI record

NPI
1932131562
Entity type
Individual (Type 1)
Enumeration date
July 6, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 145165 UT

About Dr. Tidwell

Eric Ivan Tidwell, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 777 N 500 W Ste 101a, Provo, UT 84601-1594. The NPI number 1932131562 was assigned on July 6, 2006 and the record was last updated on July 8, 2007.

Dr. Tidwell lists a license in the registry: #145165 (UT) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Eric Ivan Tidwell, DDS?

The NPI number is 1932131562.

What is the phone number of Dr. Tidwell?

The phone number listed for the practice location is (801) 373-6362.

Where is Dr. Tidwell located?

777 N 500 W Ste 101a, Provo, UT 84601-1594.

What is the taxonomy code for Dr. Tidwell?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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