Andrew Brian Bullard, DMD
Individual provider Active NPI General Practice Dentistry · Greenville, SC
NPI 1043616352 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1043616352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3674 (SC)
- Practice address
- 644 N Main St Ste 111
Greenville, SC 29601-1678 - Phone
- (864) 520-2942
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3674 | SC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenville Dental Studio | Current |
Accepting new patients | |
| Comprehensive and Cosmetic Dental Studio of Greenville | Current |
Accepting new patients |
Locations
644 N Main St
Ste 111
Greenville, SC 29601
Phone (864) 520-2942
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3674 | SC | Yes |
Addresses
Primary practice location
644 N Main St Ste 111
Greenville, SC 29601-1678
Mailing address
644 N Main St Ste 111
Greenville, SC 29601-1678
Phone (864) 520-2942
Other providers in Greenville, SC
- Maitram Bui
- Stacy Schaefer Buice
- Sarah Jane Buitrago
- Douglas Middleton Bull
- Evelyn Louise Bull
- Julius David Bullard III
- Andrew Ritchie Bullock
- Hope Bullock
- Zachary Bumgarner
- Allison Danielle Bumpas
All providers in Greenville, SC · General Practice Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.