Provider Demographics
NPI:1962820951
Name:MARIANNE AYERS DMD, PA
Entity Type:Organization
Organization Name:MARIANNE AYERS DMD, PA
Other - Org Name:FOOTHILLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:ORR
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-245-0680
Mailing Address - Street 1:7005 CALHOUN MEMORIAL HWY
Mailing Address - Street 2:UNIT B
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3566
Mailing Address - Country:US
Mailing Address - Phone:864-306-0800
Mailing Address - Fax:
Practice Address - Street 1:1040 S PENDLETON ST
Practice Address - Street 2:UNIT C
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1047
Practice Address - Country:US
Practice Address - Phone:864-306-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC69041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty