| Edward J. Clemons Jr., Dds, Pa | |
|
5011 Southpark Dr Suite 110 Durham NC 27713-7738 | |
| (919) 361-9700 | |
| (919) 361-9747 |
| Full Name | Edward J. Clemons Jr., Dds, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5011 Southpark Dr, Durham, North Carolina |
| Authorized Official Name and Position | Edward Jacob Clemons (OWNER/DENTIST) |
| Authorized Official Contact | 9193619700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward J. Clemons Jr., Dds, Pa 5011 Southpark Dr Suite 110 Durham NC 27713-7738 Ph: (919) 361-9700 | Edward J. Clemons Jr., Dds, Pa 5011 Southpark Dr Suite 110 Durham NC 27713-7738 Ph: (919) 361-9700 |
| NPI Number | 1235315771 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 06/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235315771 | NPI | - | NPPES |
| 91662 | Other | NC | BCBS |
| 8991662 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5581 (North Carolina) | Primary |
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