Healthcare Provider Details

I. General information

NPI: 1609780253
Provider Name (Legal Business Name): PROGRIN DENTAL OF NORTH ANDERSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PROFESSIONAL CT
ANDERSON SC
29621-2052
US

IV. Provider business mailing address

201 OLD BOILING SPRINGS RD
GREER SC
29650-4227
US

V. Phone/Fax

Practice location:
  • Phone: 864-561-7559
  • Fax:
Mailing address:
  • Phone: 864-561-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: GREGORY AYERS
Title or Position: MEMBER
Credential: DMD
Phone: 864-561-7559