Individual
ANNA TYSON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
6420 GARNERS FERRY RD STE X, COLUMBIA, SC 29209-1632
(803) 528-8351
Mailing address
6420 GARNERS FERRY RD STE X, COLUMBIA, SC 29209-1632
(803) 661-8412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4334
SC
Other
Enumeration date
06/20/2007
Last updated
04/22/2023
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