Individual
DR. LIONEL THOMAS FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5879 HIGHWAY 707, MYRTLE BEACH, SC 29588-7359
(843) 650-4707
(843) 650-5151
Mailing address
2842 HARVARD RD, CHARLESTON, SC 29414-7030
(843) 556-2421
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1732
SC
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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