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Organization
BLUE RIDGE ORAL AND MAXILLOFACIAL SURGERY PA
Active
Organization
BLUE RIDGE ORAL AND MAXILLOFACIAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC MCGILL BRYANT SR. DMD (PRESIDENT)
(843) 267-5882
Entity
Organization
Contact information
Practice address
209 E HIGHLAND AVE, ANDERSON, SC 29621-4711
(843) 267-5882
Mailing address
209 E HIGHLAND AVE, ANDERSON, SC 29621-4711
(843) 267-5882
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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