Provider Demographics
NPI:1760751523
Name:DENT NOW CORPARATION
Entity Type:Organization
Organization Name:DENT NOW CORPARATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GAMBRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-517-3776
Mailing Address - Street 1:16 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4070
Mailing Address - Country:US
Mailing Address - Phone:864-235-7500
Mailing Address - Fax:864-261-6988
Practice Address - Street 1:4130 CLEMSON BLVD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1108
Practice Address - Country:US
Practice Address - Phone:864-332-1266
Practice Address - Fax:864-261-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty