Provider Demographics
NPI:1649485236
Name:BYRD, TAMMI O (RDH)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:O
Last Name:BYRD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 LAUREL BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-0967
Mailing Address - Country:US
Mailing Address - Phone:803-348-2973
Mailing Address - Fax:803-407-7938
Practice Address - Street 1:100 OLD CHEROKEE RD
Practice Address - Street 2:SUITE F PMB 14
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9316
Practice Address - Country:US
Practice Address - Phone:803-808-2950
Practice Address - Fax:803-808-5642
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC927124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist