Provider Demographics
NPI:1205858172
Name:HIGGINBOTHAM & NEASE ORTHODONTICS, P.A.
Entity Type:Organization
Organization Name:HIGGINBOTHAM & NEASE ORTHODONTICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:864-579-7700
Mailing Address - Street 1:2455 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1415
Mailing Address - Country:US
Mailing Address - Phone:864-579-7700
Mailing Address - Fax:864-579-7703
Practice Address - Street 1:2455 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1415
Practice Address - Country:US
Practice Address - Phone:864-579-7700
Practice Address - Fax:864-579-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0036411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty