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General NPI Number Information
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NPI Number | 1730393299
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Entity Type | Organization
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Legal Business Name | JASON A SINGLE DDS LLC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 BUFORD AVE SUITE A
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City | ANDERSON
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State | SC
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Zip | 29621-3363
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Country | US
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Telephone | 864-224-2325
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Fax |
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Provider Business Mailing Address
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Address Line | 102 BUFORD AVE SUITE A
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City | ANDERSON
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State | SC
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Zip | 29621-3363
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Country | US
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Telephone | 864-224-2325
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JASON ANDREW SINGLE
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Credential | D.D.S.
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Telephone | 864-224-2325
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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 | 4072
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License Number State | SC
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