Provider Demographics
NPI:1053623611
Name:HYMAN, ASHLEY BROOKE (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BROOKE
Last Name:HYMAN
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 1:1470 TOBIAS GADSON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4707
Mailing Address - Country:US
Mailing Address - Phone:843-556-9939
Mailing Address - Fax:843-769-6625
Practice Address - Street 1:1470 TOBIAS GADSON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4707
Practice Address - Country:US
Practice Address - Phone:843-556-9939
Practice Address - Fax:843-769-6625
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-11
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice