Individual
DR. TODD S BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
622 S MAIN ST, MULLINS, SC 29574-3512
(843) 464-6162
(843) 464-6162
Mailing address
622 S MAIN ST, MULLINS, SC 29574-3512
(843) 464-6162
(843) 464-6162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3485
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z34856
—
SC
Enumeration date
12/15/2005
Last updated
07/08/2007
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