Individual
DR. VANCE CUTLER SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4605 OLEANDER DR STE A, MYRTLE BEACH, SC 29577-5739
(843) 449-9413
Mailing address
4605 OLEANDER DR STE A, MYRTLE BEACH, SC 29577-5739
(843) 449-9413
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
2299
SC
1223P0221X
Pediatric Dentistry
Primary
248
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899777C
—
NC
05
—
ZZ2299
—
SC
Enumeration date
01/15/2007
Last updated
07/08/2007
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