Individual
BRIAN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
153 SCENIC PLAZA DR, WEST UNION, SC 29696-2536
(864) 638-5631
Mailing address
1705 CROSS CREEK DR, SENECA, SC 29678-1616
(864) 886-8471
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3445
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX3445
—
SC
Enumeration date
09/24/2006
Last updated
07/09/2007
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