Provider Demographics
NPI:1861963704
Name:CYZMAN, GAIL JOAN (RDH)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:JOAN
Last Name:CYZMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2748 GASTON GATE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7925
Mailing Address - Country:US
Mailing Address - Phone:843-324-0117
Mailing Address - Fax:
Practice Address - Street 1:929 BOWMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3237
Practice Address - Country:US
Practice Address - Phone:843-971-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist