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General NPI Number Information
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NPI Number | 1346823473
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Entity Type | Organization
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Legal Business Name | PROGRIN DENTAL OF NORTH GREER, LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 706 N MAIN ST
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City | GREER
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State | SC
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Zip | 29651-1204
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Country | US
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Telephone | 864-561-7559
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Fax |
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Provider Business Mailing Address
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Address Line | 201 OLD BOILING SPRINGS RD
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City | GREER
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State | SC
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Zip | 29650-4227
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Country | US
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Telephone | 864-561-7559
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. BRENT AYERS
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Credential |
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Telephone | 864-561-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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