Individual
MR. BRUCE ALLEN HOLDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
341 NEWBERRY ST NW, AIKEN, SC 29801
(803) 649-0044
(803) 643-0570
Mailing address
PO BOX 1057, AIKEN, SC 29802-1057
(803) 649-0044
(803) 643-0570
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3111
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972848
UNITED CONCORDIA
—
05
—
Z31118
—
SC
Enumeration date
07/02/2006
Last updated
07/08/2007
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