Provider Demographics
NPI:1396840666
Name:CAOVETTE, TAMARA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:MARIE
Last Name:CAOVETTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 EAST MAIN STREET
Mailing Address - Street 2:WICOMICO COUNTY HEALTH DEPARTMENT VILLAGE DENTAL CLINIC
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-334-3401
Mailing Address - Fax:410-546-5090
Practice Address - Street 1:1001 LAKE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-334-3401
Practice Address - Fax:410-546-5090
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLL503122300000X
CO8464122300000X
WV3630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9181300OtherDORAL
MD006705900Medicaid
MD278470OtherDBP