Individual
DR. RYAN PATRICK MACRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
635 OLD GREENVILLE HWY, CLEMSON, SC 29631-1219
(864) 722-9255
Mailing address
635 OLD GREENVILLE HWY, CLEMSON, SC 29631-1219
(864) 722-9255
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4031
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-1710817
FEDERAL TAX ID
SC
Enumeration date
09/27/2006
Last updated
02/03/2012
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