Individual
DR. TRACI LENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
512 N PINE ST, SUMMERVILLE, SC 29483-6555
(843) 873-1202
(843) 873-4962
Mailing address
512 N PINE ST, SUMMERVILLE, SC 29483-6555
(843) 873-1202
(843) 873-4962
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3037
SC
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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