Progrin Dental of Boiling Springs LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROGRIN DENTAL OF BOILING SPRINGS LLC

Doing business as

ProGrin Dental

Practice address

8810 Highway 9
Inman, SC 29349-8718

Phone

(864) 592-1647

Fax

(864) 592-0630

NPI assigned

Jun 19, 2012

Last updated

Jun 19, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brent Allen Ayers

Title

President

Phone

(864) 561-7559

Specialties & licenses 1

Addresses

Other names 1

• ProGrin Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kirkland Woodruff Clark III, D.M.D

  • Dentist
  • Inman, SC
  • NPI 1164675252
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1063775633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293490038",
            "telephone_number": "864-592-1647",
            "fax_number": "864-592-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 HIGHWAY 9",
            "city": "INMAN",
            "state": "SC",
            "postal_code": "293498718",
            "telephone_number": "864-592-1647",
            "fax_number": "864-592-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRIN DENTAL OF BOILING SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "AYERS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-561-7559",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProGrin Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Inman, SC
• Providers in Inman, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.