Provider Demographics
NPI:1659575603
Name:DAHLKEMPER, NICOLE LYNN (DMD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:DAHLKEMPER
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 1:1203 TWO ISLAND CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7405
Mailing Address - Country:US
Mailing Address - Phone:843-884-6166
Mailing Address - Fax:843-884-1140
Practice Address - Street 1:1203 TWO ISLAND CT
Practice Address - Street 2:SUITE 101
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7405
Practice Address - Country:US
Practice Address - Phone:843-884-6166
Practice Address - Fax:843-884-1140
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC46901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice