Individual
DR. TRISTAN GREENWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5 PROFESSIONAL VILLAGE CIR, BEAUFORT, SC 29907-1571
(843) 521-0808
(843) 521-0945
Mailing address
5 PROFESSIONAL VILLAGE CIR, BEAUFORT, SC 29907-1571
(843) 521-0808
(843) 521-0945
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3760
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9682
—
SC
Enumeration date
11/21/2005
Last updated
07/08/2007
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