Individual
DR. BRUCE ALAN BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5501 WOODSIDE AVE, MYRTLE BEACH, SC 29577-2243
(843) 449-5035
Mailing address
5501 WOODSIDE AVE, MYRTLE BEACH, SC 29577-2243
(843) 449-5035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2973
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9831
—
SC
Enumeration date
01/09/2007
Last updated
07/08/2007
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