Provider Demographics
NPI:1407727365
Name:CAROLINA OAKS BELTON LLC
Entity type:Organization
Organization Name:CAROLINA OAKS BELTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:864-616-7352
Mailing Address - Street 1:1000 PINE TOP RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-9539
Mailing Address - Country:US
Mailing Address - Phone:864-338-6589
Mailing Address - Fax:
Practice Address - Street 1:1000 PINE TOP RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-9539
Practice Address - Country:US
Practice Address - Phone:864-338-6589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty