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Bill Tidwell, DDS — NPI 1053391797, Fort Defiance, AZ | NPI Central

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NPI 1053391797

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Bill Tidwell, DDS

NPI 1053391797 · General Practice Dentistry · Fort Defiance, AZ

Provider details

NPI number: 1053391797
Entity type: Individual
Primary specialty: General Practice DentistryDental Providers
Credential: DDS
Sex: Male
Sole proprietor: Yes
License: 117592 (AK)

Specialties & taxonomies

General Practice DentistryPrimary1223G0001XLicense 6993 (KS)
Dental Providers
General Practice Dentistry1223G0001XLicense 117592 (AK)
Dental Providers
General Practice Dentistry1223G0001XLicense 7367 (CO)
Dental Providers
General Practice Dentistry1223G0001XLicense 14581 (TX)
Dental Providers

Practice location

Corner of Route N12 and N7

Fort Defiance, AZ 86504-0589

Phone: (928) 729-8000

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

Po Box 1801

Fort Defiance, AZ 86504-1801

Registry dates

Enumerated: 2006-01-19
Last updated: 2019-10-18

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.