# BLUE RIDGE ORAL AND MAXILLOFACIAL SURGERY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598173627
- **Authorized official:** ERIC MCGILL BRYANT SR. DMD (PRESIDENT)
- **Authorized official phone:** (843) 267-5882

## Contact information

- **Practice address:** 209 E HIGHLAND AVE, ANDERSON, SC 29621-4711
- **Practice address phone:** (843) 267-5882
- **Mailing address:** 209 E HIGHLAND AVE, ANDERSON, SC 29621-4711
- **Mailing address phone:** (843) 267-5882

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2014
- **Last updated:** 08/01/2014