Individual
MRS. CHERMAINE LATRICE LYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8063 EDMUND HWY, PELION, SC 29123-9805
(803) 894-3736
(803) 894-5315
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4423
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4423
—
SC
Enumeration date
08/04/2008
Last updated
11/01/2016
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