| Laurens Dentistry, Llc | |
|
810 E Main St Suite G Laurens SC 29360-3535 | |
| (864) 715-0688 | |
| Not Available |
| Full Name | Laurens Dentistry, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 810 E Main St, Laurens, South Carolina |
| Authorized Official Name and Position | Jason Scott Rogers (OWNER/DENTIST) |
| Authorized Official Contact | 8647150688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurens Dentistry, Llc 810 E Main St Suite G Laurens SC 29360-3535 Ph: (864) 715-0688 | Laurens Dentistry, Llc 810 E Main St Suite G Laurens SC 29360-3535 Ph: (864) 715-0688 |
| NPI Number | 1902038052 |
|---|---|
| Provider Enumeration Date | 08/21/2009 |
| Last Update Date | 08/21/2009 |
| Medicare PECOS PAC ID | 0042621104 |
|---|---|
| Medicare Enrollment ID | O20201120000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902038052 | NPI | - | NPPES |
| ZX4024 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4024 (South Carolina) | Primary |
| Provider Name | Jason Scott Rogers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609980036 PECOS PAC ID: 9436462900 Enrollment ID: I20201120000308 |
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