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General NPI Number Information
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NPI Number | 1588656656
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Entity Type | Organization
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Legal Business Name | SPROGIS & SPROGIS DDS PA
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6B CLEVELAND CT
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City | GREENVILLE
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State | SC
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Zip | 29607-2414
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Country | US
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Telephone | 864-271-6213
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Fax | 864-271-3970
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Provider Business Mailing Address
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Address Line | 6B CLEVELAND CT
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City | GREENVILLE
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State | SC
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Zip | 29607-2414
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Country | US
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Telephone | 864-271-6213
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Fax | 864-271-3970
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Authorized Official
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Title or Position | VICE PRESIDENT OF MY CORPORATION
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Name | DR. LESLIE ANN SPROGIS
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Credential | DDS
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Telephone | 864-271-6215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2548
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License Number State | SC
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