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Organization
COMPREHENSIVE AND COSMETIC DENTAL STUDIO OF GREENVILLE
Active
Organization
COMPREHENSIVE AND COSMETIC DENTAL STUDIO OF GREENVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW BRIAN BULLARD DMD (PRESIDENT)
(864) 907-4684
Entity
Organization
Contact information
Practice address
644 N MAIN ST STE 111, GREENVILLE, SC 29601-1678
(864) 520-2942
Mailing address
644 N MAIN ST STE 111, GREENVILLE, SC 29601-1678
(864) 520-2942
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3674
SC
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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