Individual
TYLER LOVELLE NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4400 DORCHESTER RD, CHARLESTON, SC 29405-6849
(843) 790-0626
Mailing address
1402 CAMP RD APT 10G, CHARLESTON, SC 29412-3720
(803) 269-3903
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10593
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
SC
Other
Enumeration date
02/20/2023
Last updated
07/31/2023
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