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Organization
CLEMONS COSMETIC & FAMILY DENTISTRY
Active
Organization
CLEMONS COSMETIC & FAMILY DENTISTRY
Active
Other names
Edward J. Clemons Jr., DDS, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD JACOB CLEMONS JR. DDS (OWNER/DENTIST)
(919) 361-9700
Entity
Organization
Contact information
Practice address
5011 SOUTHPARK DR, SUITE 110, DURHAM, NC 27713-7738
(919) 361-9700
(919) 361-9747
Mailing address
5011 SOUTHPARK DR, SUITE 110, DURHAM, NC 27713-7738
(919) 361-9700
(919) 361-9747
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5581
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991662
—
NC
01
—
91662
BCBS
NC
Enumeration date
01/15/2008
Last updated
06/29/2015
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