Provider Demographics
NPI:1063645729
Name:JOHN E. ROSS, III, DMD
Entity Type:Organization
Organization Name:JOHN E. ROSS, III, DMD
Other - Org Name:CALHOUN CLEMSON DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-654-4882
Mailing Address - Street 1:602 COLLEGE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-2823
Mailing Address - Country:US
Mailing Address - Phone:864-654-4882
Mailing Address - Fax:864-654-0139
Practice Address - Street 1:602 COLLEGE AVE STE 1
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2823
Practice Address - Country:US
Practice Address - Phone:864-654-4882
Practice Address - Fax:864-654-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental