Organization
TOLLISON ORTHO LLC
Active
Other names
Tollison Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE LEWIS TOLLISON DMD, MSD (OWNER)
(864) 329-1971
Entity
Organization
Contact information
Practice address
20A CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 329-1971
Mailing address
20 CREEKVIEW CT STE A, GREENVILLE, SC 29615-4800
(864) 329-1971
(864) 329-1973
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
05/12/2025
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