Individual
MRS. TIESHA GISELLE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HYGIENIST
Contact information
Practice address
4323 HILL ST, COLUMBIA, SC 29207-6022
(843) 731-4380
Mailing address
2309 PINE HILL CT LOT 15, FLORENCE, SC 29506-5127
(843) 731-4380
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
8255
SC
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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