Individual
DR. TYLER KEITH LIPHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
458 W WASHINGTON ST, MONTICELLO, GA 31064-1368
(706) 468-6394
(706) 468-8113
Mailing address
120 DELL AVE, ATHENS, GA 30606-3406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015668
GA
Other
Enumeration date
06/24/2018
Last updated
12/04/2023
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