Organization
PROGRIN DENTAL OF FIVE FORKS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY AYERS (OWNER)
(864) 561-7559
Entity
Organization
Contact information
Practice address
2098 WOODRUFF RD, GREENVILLE, SC 29607-5939
(864) 254-6414
Mailing address
201 OLD BOILING SPRINGS RD STE A, GREER, SC 29650-4257
(864) 561-7559
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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