Organization
LAURENS DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ROGERS DMD (OWNER)
(864) 715-0688
Entity
Organization
Contact information
Practice address
810 E MAIN ST, SUITE G, LAURENS, SC 29360-3547
(864) 715-0688
Mailing address
810 E MAIN ST, SUITE G, LAURENS, SC 29360-3547
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
4024
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4024
—
SC
Enumeration date
10/18/2016
Last updated
10/18/2016
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