Organization
CONYERS DENTAL LLC
Active
Other names
Olde Town Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN C EDWARDS DMD (OWNER)
(864) 859-0111
Entity
Organization
Contact information
Practice address
1317 MILSTEAD AVE NE, CONYERS, GA 30012-3829
(770) 760-0036
(770) 760-9100
Mailing address
415 S PENDLETON ST, EASLEY, SC 29640-3051
(864) 859-0111
(864) 859-0112
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
01/12/2021
Last updated
03/18/2025
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