Organization
GYE NYAME LLC
Active
Other names
Children's Dental Group of South Carolina
Organization subpart
No
Provider details
NPI number
Authorized official
TASHIBA NELSON DMD (OWNER)
(803) 781-5141
Entity
Organization
Contact information
Practice address
7210 BROAD RIVER RD STE K, IRMO, SC 29063-8150
(803) 781-5141
Mailing address
7210 BROAD RIVER RD STE K, IRMO, SC 29063-8150
(803) 781-5141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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