Individual
DR. TYLER KELLUM LEVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
201 E. VILLANOW STREET, LAFAYETTE, GA 30728
(706) 638-2784
(706) 638-7428
Mailing address
201 E. VILLANOW STREET, LAFAYETTE, GA 30728
(706) 638-2784
(706) 638-7428
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015053
GA
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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