Provider Demographics
NPI:1508011982
Name:NORTH SPRINGS DENTISTRY
Entity Type:Organization
Organization Name:NORTH SPRINGS DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-736-9392
Mailing Address - Street 1:2000 CLEMSON RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9538
Mailing Address - Country:US
Mailing Address - Phone:803-736-9392
Mailing Address - Fax:803-736-9202
Practice Address - Street 1:2000 CLEMSON RD
Practice Address - Street 2:SUITE 15
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9538
Practice Address - Country:US
Practice Address - Phone:803-736-9392
Practice Address - Fax:803-736-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3357261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental