Provider Demographics
NPI:1447778477
Name:TINSLEY, LINDA BRANTLEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:BRANTLEE
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 HARBORSUN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8273
Mailing Address - Country:US
Mailing Address - Phone:864-980-6798
Mailing Address - Fax:
Practice Address - Street 1:5621 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6022
Practice Address - Country:US
Practice Address - Phone:843-557-5396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice