Provider Demographics
NPI:1770535213
Name:BIEHL, BRIAN LEE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:LEE
Last Name:BIEHL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BEN CASEY DR
Mailing Address - Street 2:SUITE 139
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6478
Mailing Address - Country:US
Mailing Address - Phone:803-547-5002
Mailing Address - Fax:803-547-5228
Practice Address - Street 1:105 BEN CASEY DR
Practice Address - Street 2:SUITE 139
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6478
Practice Address - Country:US
Practice Address - Phone:803-547-5002
Practice Address - Fax:803-547-5228
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3644Medicaid