Healthcare Provider Details

I. General information

NPI: 1245197672
Provider Name (Legal Business Name): MAY RIVER ENDODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NEW RIVERSIDE VILLAGE WAY UNIT 203
BLUFFTON SC
29910-3448
US

IV. Provider business mailing address

255 NEW RIVERSIDE VILLAGE WAY UNIT 203
BLUFFTON SC
29910-3448
US

V. Phone/Fax

Practice location:
  • Phone: 843-949-4945
  • Fax: 843-949-4947
Mailing address:
  • Phone: 843-949-4945
  • Fax: 843-949-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW BRADLEY
Title or Position: OWNER
Credential: DMD
Phone: 843-949-4945