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Organization
LAURENS DENTISTRY, LLC
Active
Organization
LAURENS DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON SCOTT ROGERS DMD (OWNER/DENTIST)
(864) 715-0688
Entity
Organization
Contact information
Practice address
810 E MAIN ST, SUITE G, LAURENS, SC 29360-3535
(864) 715-0688
Mailing address
810 E MAIN ST, SUITE G, LAURENS, SC 29360-3535
(864) 715-0688
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4024
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4024
—
SC
Enumeration date
08/21/2009
Last updated
08/21/2009
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