Individual
ALLEN TIMOTHY LOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
631 N CHURCH ST, SPARTANBURG, SC 29303-3046
(864) 308-1355
Mailing address
631 N CHURCH ST, SPARTANBURG, SC 29303-3046
(864) 308-1355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DGD.9665
SC
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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