Individual
MR. LYNN B FADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
35 BILL FRIES DRIVE, BLDG D, HILTON HEAD ISLAND, SC 29926-2731
(843) 689-6338
(843) 689-2155
Mailing address
35 BILL FRIES DRIVE, BLDG D, HILTON HEAD ISLAND, SC 29926-2731
(843) 689-6338
(843) 689-2155
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4162
—
SC
Enumeration date
05/16/2006
Last updated
10/25/2007
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